Cardiogenic Shock

As the only advanced heart failure program in Louisiana, Ochsner can provide advanced and complex treatment options for cardiogenic shock, including:

• Extracorporeal membrane oxygenation: Known as ECMO, this is a life support machine that replaces the function of a person’s heart and lungs.
• Intra-aortic balloon pump: This mechanical device helps the heart pump more blood.
• Mechanical circulatory support: These are devices, such as ventricular assist devices or left ventricular assist devices, that help the heart function better.
• Percutaneous coronary intervention: This minimally invasive procedure is an option for patients who have a completely blocked artery in the heart.
• Heart transplant: Available at the Ochsner Transplant Institute, heart transplants are a treatment option available when other, less intense options won’t work.

The Ochsner cardiogenic shock team provides care overseen by fellowship-trained, board-certified cardiology specialists, including heart failure cardiologists and critical care physicians.

Our team includes interventional cardiologists who are national leaders from the Society for Cardiac Angiography & Interventions and the Society for Vascular Medicine. When a patient is in cardiogenic shock, the patient’s doctor will reach out to the cardiogenic shock team to get expert advice about next steps.

The four stages are:

1. Initial. During the initial stage, patients experience decreased performance of their heart but don’t exhibit symptoms.
2. Compensatory. The body starts to respond by releasing hormones to try to increase heart rate.
3. Progressive. During this stage, the heart is under increased stress that can eventually lead to metabolic acidosis (buildup of acid in the body) and fluid leakage from capillaries (the part of blood vessels that allow oxygen and nutrient exchange between blood and tissue). This can cause capillary clotting and tissue death.
4. Refractory. The body experiences organ failure, stroke and potentially death.

When a patient enters cardiogenic shock, nurses typically alert the physician, assess and monitor vital signs and prepare for any necessary procedures.

Treatments include medication and medical procedures, such as angioplasty and stenting. Medical devices, such as extracorporeal membrane oxygenation, intra-aortic balloon pump or mechanical circulatory support, may also be needed.