What are the four stages of cardiogenic shock?

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.

Cardiogenic Shock

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Cardiogenic shock at Ochsner

Ochsner Health cardiogenic shock experts are located in New Orleans, Louisiana. Home to the only advanced heart failure program in the state, we offer comprehensive, cutting-edge treatment options designed to address even the most complex cases of cardiogenic shock.

The Ochsner cardiogenic shock care team is led by fellowship-trained, board-certified cardiology experts, including specialists in heart failure and critical care. This ensures every patient benefits from the highest level of medical expertise. The team also includes interventional cardiologists who are recognized leaders in national organizations such as the Society for Cardiac Angiography & Interventions and the Society for Vascular Medicine.

In cases of cardiogenic shock, we take a collaborative team approach. Physicians partner with our specialized team to determine the best course of action, combining their expertise to ensure patients receive the most effective care available.

At Ochsner, we are committed to innovation, excellence and compassionate care. With our advanced resources and highly qualified team, we are here to guide you toward better outcomes and a healthier future.

Cardiogenic shock occurs when the heart can’t pump enough blood to the brain or body. While this condition is a life-threatening emergency, it can be treated if it's diagnosed right away.

Cardiogenic shock is often caused by a heart attack, heart failure, chest injuries or blood clots in the lungs. Symptoms can include:

Confusion
Rapid breathing
Sweating
Low blood pressure, with the top number below 90

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.

FAQs

The four stages are:

Initial. During the initial stage, patients experience decreased performance of their heart but don’t exhibit symptoms.
Compensatory. The body starts to respond by releasing hormones to try to increase heart rate.
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.
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.