Cardiogenic Shock

The primary function of the cardiovascular system is to provide oxygen and energy substrates to the body's tissues. In all forms of shock, there is metabolic failure a downstream consequence of an inability to meet the metabolic demands of the tissue. In cardiogenic shock, the primary derangement leading to unmet tissue metabolic demands is cardiac dysfunction. Though cardiac impairment may be implicated in other categories of shock, primary cardiac failure in the form of cardiogenic shock is the third most common type of shock in pediatrics – trailing septic shock and hypovolemic shock. Myocardial malfunction, in other forms of shock, is secondary to ischemia, acidosis, drugs, toxins, or direct myocardial depressants due to inflammation. Cardiogenic shock, a low-output state, is characterized by elevated ventricular filling pressures, low cardiac output, systemic hypotension, and evidence of end-organ hypoperfusion. Herein, we will highlight the pathophysiology of cardiogenic shock, the various causative etiologies, the multitude of laboratory or imaging diagnostic options, current advances in therapies, and outcomes in patients.