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Cardiogenic Shock

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Cardiogenic shock is a life-threatening medical emergency that occurs when the heart is unable to pump enough blood to adequately supply vital organs, even when the body has a normal amount of blood. As a result, tissues and organs throughout the body are suddenly deprived of adequate blood flow and oxygen.
Without prompt treatment, cardiogenic shock can lead to organ failure and can be fatal.
Although cardiogenic shock is relatively uncommon, it is a serious condition with a high mortality rate. Early recognition and urgent treatment are therefore critical to improving the chances of survival.

Causes of Cardiogenic Shock
Cardiogenic shock most commonly occurs when the left ventricle, which is responsible for pumping blood to the rest of the body, is severely weakened due to a lack of oxygen caused by an acute myocardial infarction (AMI). Other possible causes include:

Causes originating within the heart
  • Myocarditis or infective endocarditis
  • Sudden, severe abnormal heart rhythms (arrhythmias)
  • Acute structural damage to the heart, such as acute mitral regurgitation or ventricular septal rupture
  • Hypertrophic obstructive cardiomyopathy (HOCM)
  • Severe valvular heart disease, particularly aortic stenosis
  • Severe weakening of the heart muscle from other causes, including drug overdose or toxicity
Causes outside the heart
  • Acute and severe pulmonary embolism
  • Tension pneumothorax
  • Severe sepsis, which can impair heart function (septic cardiomyopathy)
  • Metabolic abnormalities, such as severe acidosis or low blood calcium levels
  • Thyroid storm (thyrotoxic crisis)
  • Symptoms of cardiogenic shock usually develop quickly and may include:
  • Severe shortness of breath or very rapid breathing
  • Abnormally rapid heartbeat with a weak pulse
  • Cold, clammy skin, especially on the hands and feet
  • Low blood pressure
  • Swelling of the legs and abdomen
  • Confusion, dizziness, or loss of consciousness
  • Little or no urine output


If you or someone nearby has these symptoms, call 1669 or go to the nearest emergency department immediately.
Among people who have had a heart attack, the risk of cardiogenic shock may be higher in:
  • People aged 75 or older
  • Women
  • People with a history of heart failure or a previous heart attack
  • People with underlying conditions such as diabetes, high blood pressure, high cholesterol, coronary artery disease, or obesity
  • People who smoke
  • People who are physically inactive
If not treated promptly, cardiogenic shock can cause inadequate blood flow to vital organs such as the brain, kidneys, liver, and lungs, potentially resulting in permanent organ damage. It can also lead to multiple organ failure and significantly increase the risk of death.
 
Cardiogenic shock requires emergency hospital treatment, usually in an intensive care unit (ICU), by a specialized medical team. The primary goals are to restore adequate blood circulation and oxygen delivery to vital organs and prevent permanent organ damage. Treatment may involve the following steps:


1. Assessing and supporting breathing and circulation
  • This may include:Mechanical ventilation to support breathing
  • Intravenous (IV) fluids and medications
  • Medications that strengthen the heart’s pumping action or raise blood pressure
  • Diuretics to remove excess fluid from the body
In some cases, a pulmonary artery (Swan-Ganz) catheter may be inserted to monitor pressures in the heart and lungs and how well the heart is pumping.
2. Treating the underlying cause
  • Blocked coronary arteries (heart attack): Coronary angioplasty and stenting (percutaneous coronary intervention, PCI) or coronary artery bypass grafting (CABG)
  • Heart valve problems: Surgical repair or replacement of the affected valve
  • Abnormal heart rhythms: Electrical cardioversion, catheter ablation, or implantation of a pacemaker or implantable cardioverter-defibrillator (ICD), depending on the condition
3. Advanced heart support and heart transplantation
If medications alone are not enough to support the heart, advanced treatment options may include:
  • ECMO (extracorporeal membrane oxygenation): Provides temporary support for heart and lung function, buying time for the heart and lungs to recover or for further treatment to be planned
  • pVAD (percutaneous ventricular assist device), such as Impella: Provides temporary mechanical support to the heart, helping to increase blood flow to vital organs
  • LVAD (left ventricular assist device): Provides long-term mechanical support for the left ventricle and may serve as a bridge to heart transplantation or as long-term (destination) therapy
  • Heart transplantation: Surgical replacement of the diseased heart with a donor heart in eligible patients
The best way to reduce the risk of cardiogenic shock is to prevent coronary artery disease and seek early treatment for existing heart conditions. Other ways to reduce the risk include:
  • Manage underlying health conditions and follow your doctor’s advice
  • Maintain a healthy body weight
  • Avoid smoking
  • Limit alcohol consumption
  • Eat a healthy diet rich in vegetables, fruits, whole grains, and fish, and limit sugary, fatty, salty, and processed foods
  • Exercise regularly
  • Get adequate sleep and manage stress
At the Bumrungrad Heart Institute, we are equipped to respond to this critical condition, which requires immediate and specialized care.

Our multidisciplinary team of specialized physicians and healthcare professionals works around the clock, supported by advanced medical technology and a full range of specialized equipment. This enables us to provide timely and appropriate treatment while prioritizing patient safety during critical situations.
 
Last modify: September 24, 2026

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