What are appropriate interventions for cardiogenic shock?
Medications to treat cardiogenic shock are given to increase your heart’s pumping ability and reduce the risk of blood clots.
- Vasopressors. These medications are used to treat low blood pressure.
- Inotropic agents.
- Aspirin.
- Antiplatelet medication.
- Other blood-thinning medications.
What is cardiogenic shock treatment?
The goal of cardiogenic shock treatment is to quickly restore blood pressure and heart function. This often requires a series of emergency treatments that are given in an ambulance or the Emergency Department. Other treatments may include medications or temporary support devices to restore blood flow.
What is the drug of choice for cardiogenic shock?
Dobutamine is the drug of choice in patients with a systolic pressure higher than 80 mmHg. Dopamine exerts direct effects on the heart via beta 1 receptors present on cardiac myocytes and indirect effects by releasing norepinephrine. This increases the heart rate and raises the blood pressure.
What is contraindicated in cardiogenic shock?
Beta blockers are contraindicated when risk factors for cardiogenic shock are present (class III) Administer initial therapy with channel calcium blockers in patients with increased risk for cardiogenic shock (class I; level of evidence, B)
What treatment should be used cautiously in patients with cardiogenic shock?
Aspirin should be given to symptomatic patients. Beta blockers should be used cautiously in the acute setting because they may increase the risk of cardiogenic shock and death.
Why is dobutamine used in cardiogenic shock?
In patients with cardiogenic shock due to decompensated heart failure, dobutamine decreases left ventricular end-diastolic pressure and raises blood pressure by increasing cardiac output.
Which inotropes is used in cardiogenic shock?
| Drug | Clinical Indication |
|---|---|
| Norepinephrine | Shock (vasodilatory, cardiogenic) |
| Epinephrine | Shock (cardiogenic, vasodilatory) Cardiac arrest Bronchospasm/anaphylaxis Symptomatic bradycardia or heart block unresponsive to atropine or pacing |
| Isoproterenol | Bradyarrhythmias (especially torsade des pointes) Brugada syndrome |
What is the best vasopressor for cardiogenic shock?
A recent RCT and a meta-analysis on individual data suggested that norepinephrine may be preferred over epinephrine in patients with cardiogenic shock . For inotrope agents, when norepinephrine fails to restore perfusion, dobutamine represents the first-line agent.
What inotropes are used in cardiogenic shock?
Norepinephrine is a widely used vasopressor in cardiogenic shock that also exhibits positive inotropic properties. It acts on the alpha1 adrenergic receptors of the vasculature, thereby exerting a potent vasopressive effect with resultant increase of blood pressure.
Which vasopressor is best for cardiogenic shock?
When do you use dobutamine in cardiogenic shock?
In patients with cardiogenic shock due to decompensated heart failure, dobutamine decreases left ventricular end-diastolic pressure and raises blood pressure by increasing cardiac output. In some patients, it can induce hypotension by peripheral vasodilation due to its effect on β-2 receptors.