Shock is defined as a physiological state of inadequate blood flow to vital organs that leads to a global reduction in tissue perfusion with subsequent widespread cellular dysfunction. Three types of shock are recognized: hypovolemic shock, distributive shock, and cardiogenic shock. The most common causes of cardiogenic shock are acute MI (including extensive left ventricular injury), right ventricular infarction, ruptured papillary muscle, postinfarct septal rupture, ventricular free wall rupture with tamponade, and, uncommonly, severe ventricular stunning in association with the apical...

Shock is defined as a physiological state of inadequate blood flow to vital organs that leads to a global reduction in tissue perfusion with subsequent widespread cellular dysfunction. Three types of shock are recognized: hypovolemic shock, distributive shock, and cardiogenic shock. The most common causes of cardiogenic shock are acute MI (including extensive left ventricular injury), right ventricular infarction, ruptured papillary muscle, postinfarct septal rupture, ventricular free wall rupture with tamponade, and, uncommonly, severe ventricular stunning in association with the apical balloon (takotsubo) syndrome. Cardiogenic shock is the leading cause of death among hospitalized patients following acute MI. Cardiogenic shock is the focus of this chapter.