599:
rates to take blood out of the left ventricle and into the aorta more quickly, thereby decreasing the amount of work that the left ventricle has to do. While the
Impella is commonly used in settings of cardiogenic shock, some evidence suggests that it placing an Impella device in an acute cardiogenic shock setting, where the heart fails to pump suddenly, may not necessarily guarantee increased survival.
623:
circulator which adds oxygen and removes carbon dioxide, and ultimately returns blood back into the patient's arterial system where the newly oxygenated blood can be delivered to the person's organs. Some evidence suggests that the combination of both an
Impella device and Venous-arterial extra-corporeal membrane oxygenation may decrease the heart's
598:
of the heart and essentially acts as a pump, drawing blood from the left ventricle and pushing it out into the aorta so that it could be delivered to the rest of the body. Unlike intra-aortic balloon pumps, the
Impella acts independently from the cardiac cycle. It can be adjusted to pump at faster
579:
Intra-aortic balloon pumps have been around for several decades and are most commonly used first-line of the mechanical circulatory support devices. However, it is not without its potential complications. Potential complications include injury upon insertion of the device to arteries supplying the
235:
Mortality rates for cardiogenic shock are high but have been decreasing in the United States. This is likely due to its rapid identification and treatment in recent decades. Some studies have suggested that this is possibly related to new treatment advances. Nonetheless, the mortality rates remain
545:
Patients who have cardiogenic shock unresponsive to medication therapy may be candidates for more advanced options such as a mechanical circulatory support device. There are several types of mechanical circulatory support devices, the most common being intra-aortic balloon pumps, left ventricular
630:
Because Venous-arterial extra-corporeal membrane oxygenation is a very invasive procedure, it is not usually the first-line chosen device for patients in cardiogenic shock and is often reserved only for patients who have not only cardiogenic shock but also respiratory failure and/or concomitant
622:
Venous-arterial extra-corporeal membrane oxygenation is a circuit support system that is meant to replace the function of the heart as it heals or awaits a more definitive treatment. It consists of a circuit that essentially drains blood from a patient's venous system, runs that blood through a
191:
For patients where the cause is not due to a heart attack, the mortality rate is still relatively high, at about 60%; some progress has been made in treating cardiogenic shock when due to a heart attack, and the mortality rate is now somewhat lower for those with MI who survive and are treated
576:(the contracting phase of the cardiac cycle). Intra-aortic balloon pumps do not directly increase cardiac output, but importantly, they decrease the amount of pressure that the heart has to pump against, thereby allowing for more blood flow and oxygen to be delivered to the heart muscles.
417:; MIs that affect the ventricles are usually more dangerous than those that affect the atria; those affecting the left side of the heart, especially the left ventricle, are usually more dangerous than those affecting the right side, unless that side is severely compromised)
227:
Cardiogenic shock is a condition that is difficult to fully reverse even with an early diagnosis. However, early initiation of treatment may improve outcomes. Care should also be directed to any other organs that are affected by this lack of blood flow (e.g.,
223:
may help. Certain medications, such as dobutamine and milrinone, improve the heart's ability to contract and can also be used. When these measures fail, more advanced options such as mechanical support devices or heart transplantation can be pursued.
32:
464:
446:
1432:
1417:
546:
assist devices, and venous-arterial extra-corporeal membrane oxygenation. It is important to note, however, that none of these devices are permanent solutions but rather are a bridge to a more definitive therapy such as a
468:
467:
450:
449:
37:
35:
469:
451:
36:
580:
spinal cord as well as risks with any procedure such as bleeding and infection. Contraindications to intra-aortic balloon pumps include aortic dissection, an abdominal aortic aneurysm, and irregularly fast heart beats.
2388:
205:. Signs of inadequate blood flow include low urine production (<30 mL/hour), cool arms and legs, and decreased level of consciousness. People may also have a severely low blood pressure and heart rate.
466:
448:
34:
2302:
1933:
1316:
Ni Hlci, Tamara; Boardman, Henry MP; Baig, Kamran; Aifesehi, Paul E.; Stafford, Jody L.; Cernei, Cristina; Bodger, Owen; Westaby, Stephen; et al. (Cochrane Heart Group) (2018-04-12).
2381:
614:. Contraindications to an Impella device insertion include aortic dissection, the presence of a mechanical aortic valve, and the presence of a blood clot in the left ventricle.
1095:
2374:
1693:
219:
Treatment of cardiogenic shock depends on the cause with the initial goals to improve blood flow to the body. If cardiogenic shock is due to a heart attack, attempts to
594:
There are several types of left ventricular assist devices, with the
Impella devices being some of the most common. This device is placed by a cardiac surgeon into the
370:), or ventriculoseptal defects. It can also be caused by a sudden decompressurization (e.g. in an aircraft), where air bubbles are released into the bloodstream (
1971:
1223:"Escalating and De-escalating Temporary Mechanical Circulatory Support in Cardiogenic Shock: A Scientific Statement From the American Heart Association"
465:
447:
33:
542:, enhance the heart's pumping function and are often used first-line to improve the low blood pressure and delivery of blood to the rest of the body.
1799:
1686:
1543:
1130:
1005:
972:
937:
912:
1894:
1879:
1819:
139:
2292:
1989:
1109:
1074:
1043:
1166:
3059:
1679:
1115:
106:
721:
2135:
1994:
1927:
1145:
1064:
2266:
1601:
1029:
534:
Initial management of cardiogenic shock involves medications to augment the heart's function. Certain medications, such as
1773:
1756:
3054:
2811:
1750:
2975:
1191:
3016:
2176:
2110:
367:
334:
213:
1768:
1713:
2783:
2297:
2093:
2088:
2039:
1536:
589:
559:
748:"Temporal trends in incidence, causes, use of mechanical circulatory support and mortality in cardiogenic shock"
2539:
1447:
624:
201:
is a medical emergency resulting from inadequate blood flow to the body's organs due to the dysfunction of the
131:
3049:
2639:
2501:
2191:
2034:
2019:
1702:
1101:
436:
300:
Rapid and deeper respirations (hyperventilation) due to sympathetic nervous system stimulation and acidosis.
288:
236:
high and multi-organ failure in addition to cardiogenic shock is associated with higher rates of mortality.
113:
2271:
568:. It consists of a small balloon filled with helium that helps the heart to pump blood by inflating during
486:
2864:
2702:
2496:
2073:
1359:"Left Ventricular Unloading During Extracorporeal Membrane Oxygenation in Patients With Cardiogenic Shock"
346:
Cardiogenic shock is caused by the failure of the heart to pump effectively. It is due to damage to the
2969:
2479:
2366:
2276:
2197:
660:
547:
2995:
2902:
2806:
2711:
2524:
2506:
2128:
1948:
1583:
1529:
351:
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1827:
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655:
2734:
1149:
3010:
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2401:
2397:
2220:
2051:
1984:
1901:
1862:
1837:
1762:
1660:
1578:
1560:
606:(shearing of the blood cells) as well as the formation of lesions on the heart valve, namely the
399:
355:
259:
249:
65:
3005:
2729:
2802:
2676:
2594:
2489:
2484:
2457:
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1869:
1847:
1723:
1593:
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1244:
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1070:
1039:
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978:
968:
943:
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908:
886:
837:
777:
595:
253:
220:
53:
2907:
2878:
2719:
2634:
2606:
2599:
2584:
2427:
2181:
1852:
1573:
1370:
1357:
Russo JJ, Aleksova N, Pitcher I, Couture E, Parlow S, Faraz M, et al. (February 2019).
1337:
1329:
1288:
1234:
1141:
876:
868:
827:
819:
767:
759:
565:
432:
314:
307:
2896:
2840:
2833:
2207:
2105:
1979:
1221:
Geller BJ, Sinha SS, Kapur NK, Bakitas M, Balsam LB, Chikwe J, et al. (August 2022).
746:
Schrage B, Becher PM, GoĂźling A, Savarese G, Dabboura S, Yan I, et al. (April 2021).
643:
326:
320:
277:
229:
2963:
2935:
2816:
2778:
2744:
489:
or pulmonary artery catheter may assist in the diagnosis by providing information on the
297:(low urine output) due to inadequate blood flow to the kidneys if the condition persists.
1177:
2774:
2769:
2692:
2644:
2318:
2161:
1938:
1441:
1342:
1317:
881:
856:
832:
807:
772:
747:
632:
421:
371:
359:
347:
263:
209:
143:
1293:
1276:
3043:
3000:
2956:
2929:
2554:
2467:
2417:
2046:
2029:
1655:
1627:
855:
Thiele H, de Waha-Thiele S, Freund A, Zeymer U, Desch S, Fitzgerald S (August 2021).
518:
375:
175:
135:
119:
1080:
2845:
2764:
2622:
2474:
2447:
2439:
2355:
2256:
2123:
2115:
2061:
1999:
1963:
1953:
1857:
1814:
1650:
1568:
639:
611:
607:
490:
284:
179:
162:
154:
1498:
1192:"Introduction to management of shock for junior ICU trainees and medical students"
1049:
1452:
1239:
1222:
638:
Complications of venous-arterial extra-corporeal membrane oxygenation include an
212:, arrhythmic, and mechanical. Cardiogenic shock is most commonly precipitated by
2793:
2755:
2681:
2579:
2574:
2544:
2338:
2261:
1842:
1622:
1482:
1035:
403:
363:
323:, involving fluid back-up in the lungs due to insufficient pumping of the heart.
170:
158:
127:
123:
82:
74:
46:
1463:
1375:
1358:
2651:
2409:
2345:
2328:
2240:
2156:
2100:
1906:
1617:
1426:
1333:
690:
564:
An intra-aortic balloon pump is a device placed by a cardiac surgeon into the
535:
98:
90:
58:
982:
2627:
2333:
2215:
2151:
1516:
1512:
1493:
1202:
1197:
1172:
1015:
962:
947:
823:
603:
539:
506:
414:
395:
helps to establish the exact diagnosis and guides treatment, it may reveal:
366:
problems, ventricular outflow obstruction (i.e. systolic anterior motion in
186:
94:
1384:
1302:
1248:
890:
872:
841:
781:
1671:
1196:
Department of
Anaesthesia and Intensive Care of The Chinese University of
1171:
Department of
Anaesthesia and Intensive Care of The Chinese University of
2950:
2452:
2235:
2186:
2166:
2024:
1943:
1718:
569:
521:
falls acutely below 2.2 L/min/m, the person may be in cardiogenic shock.
294:
86:
1409:
2350:
2230:
763:
573:
303:
78:
70:
501:
When cardiomyopathy is suspected as the cause of cardiogenic shock, a
2887:
2857:
2422:
1809:
1804:
1421:
665:
502:
102:
280:) due to vasoconstriction and subsequent hypoperfusion of the skin.
2566:
2549:
627:, thereby decreasing the amount of stress on the cardiac muscles.
410:
202:
907:(8 ed.). Pearson Education Limited. 2018. pp. 172–173.
435:
may show poor ventricular function, signs of PED, rupture of the
2987:
2225:
1911:
1138:
Surgical
Critical Care Service, Department of Surgical Education
330:
2370:
1675:
1525:
232:
for the kidneys, mechanical ventilation for lung dysfunction).
905:
International Trauma Life
Support for Emergency Care Providers
602:
Potential complications specific to an
Impella device include
572:(the resting phase of the cardiac cycle) and deflating during
392:
2303:
European
Society of Paediatric and Neonatal Intensive Care
269:
A rapid, weak, thready pulse due to decreased circulation
252:
due to decreased blood flow to the brain, and subsequent
138:, respiratory or kidney or liver dysfunction or failure,
1521:
1318:"Mechanical assist devices for acute cardiogenic shock"
475:
Ultrasound showing cardiogenic shock due to myocarditis
457:
Ultrasound showing cardiogenic shock due to myocarditis
1934:
Critical illness–related corticosteroid insufficiency
1277:"Temporary circulatory support for cardiogenic shock"
1275:
Combes A, Price S, Slutsky AS, Brodie D (July 2020).
1399:
1094:
Warrell DA, Cox TM, Firth JD, Benz EJ, eds. (2003).
618:
Venous-arterial extra-corporeal membrane oxygenation
2986:
2886:
2877:
2825:
2792:
2753:
2710:
2701:
2662:
2615:
2565:
2438:
2408:
2311:
2285:
2249:
2206:
2144:
2060:
2012:
1962:
1920:
1789:
1782:
1737:
1638:
1610:
1592:
1559:
1473:
1403:
932:. Philadelphia: Lippincott Williams & Wilkins.
185:
169:
150:
112:
64:
52:
24:
806:Vahdatpour C, Collins D, Goldberg S (April 2019).
505:of heart muscle may be needed to make a definite
439:, an obstructed outflow tract or cardiomyopathy.
45:Ultrasound image after cardiogenic shock due to
192:rapidly with current therapies (February 2021)
2382:
1687:
1537:
1363:Journal of the American College of Cardiology
646:, and blood clotting in the circuit machine.
337:due to loss of blood and oxygen to the brain.
8:
1129:Cheatham ML, Block EF, Smith HG, Promes JT.
996:Society of Critical Care Medicine. (2001).
2883:
2707:
2389:
2375:
2367:
1786:
1694:
1680:
1672:
1544:
1530:
1522:
1400:
1031:Harrison's Principles of Internal Medicine
716:
714:
712:
30:
21:
1374:
1341:
1292:
1238:
1069:(22nd ed.). W. B. Saunders Company.
930:Irwin and Rippe's intensive care medicine
880:
831:
812:Journal of the American Heart Association
771:
722:"Cardiogenic shock – Symptoms and causes"
409:myocardial infarction (ST-elevation MI,
1322:Cochrane Database of Systematic Reviews
685:
683:
681:
677:
441:
1270:
1268:
1266:
1264:
1262:
1260:
1258:
1216:
1214:
1212:
1000:. Society of Critical Care Medicine.
967:. Baltimore: Williams & Wilkins.
7:
2182:Recombinant activated protein C
1063:Goldman L, Ausiello D, eds. (2003).
801:
799:
797:
795:
793:
791:
350:, most often from a heart attack or
208:Causes of cardiogenic shock include
165:, certain medications and substances
1895:Multiple organ dysfunction syndrome
1880:Acute respiratory distress syndrome
1820:Multiple organ dysfunction syndrome
244:The presentation is the following:
140:multiple organ dysfunction syndrome
691:"UOTW #7 – Ultrasound of the Week"
625:pulmonary capillary wedge pressure
14:
2293:Society of Critical Care Medicine
1990:Ventilator-associated lung injury
998:Fundamental Critical Care Support
857:"Management of cardiogenic shock"
413:, is usually more dangerous than
462:
444:
276:Cool, clammy, and mottled skin (
107:decreased level of consciousness
1995:Ventilator-associated pneumonia
1928:Critical illness polyneuropathy
1146:Orlando Regional Medical Center
1097:The Oxford Textbook of Medicine
1602:Abdominal compartment syndrome
584:Left ventricular assist device
16:Shock due to heart dysfunction
1:
1774:Geriatric intensive-care unit
1757:Pediatric intensive care unit
1294:10.1016/S0140-6736(20)31047-3
2177:Neuromuscular-blocking drugs
2120:Nutritional supplementation
1751:Neonatal intensive care unit
1240:10.1161/CIR.0000000000001076
3017:superior vena cava syndrome
2277:Water-electrolyte imbalance
2111:Early goal-directed therapy
928:Rippe JM, Irwin RS (2003).
368:hypertrophic cardiomyopathy
335:persistent vegetative state
3076:
2129:Total parenteral nutrition
2062:Life-supporting treatments
1769:Critical illness insurance
1376:10.1016/j.jacc.2018.10.085
1066:Cecil Textbook of Medicine
587:
557:
2930:radial artery sufficiency
2298:Surviving Sepsis Campaign
2094:Ventricular assist device
2089:Intra-aortic balloon pump
2040:Pulmonary artery catheter
1709:
1334:10.1002/14651858.CD013002
590:Ventricular assist device
560:Intra-aortic balloon pump
554:Intra-aortic balloon pump
313:Absent pulse in fast and
271:combined with tachycardia
221:open the heart's arteries
44:
29:
2540:Pericardial friction rub
132:ventricular fibrillation
118:Worsening of or causing
3060:Intensive care medicine
2976:Nicoladoni–Branham sign
2640:Jugular venous pressure
2502:Pulmonary insufficiency
2192:Stress ulcer prevention
2136:Therapeutic hypothermia
2035:Central venous catheter
1703:Intensive care medicine
1102:Oxford University Press
824:10.1161/JAHA.119.011991
437:interventricular septum
354:. Other causes include
289:jugular venous pressure
248:Anxiety, restlessness,
2865:Gallavardin phenomenon
2703:Cardiovascular disease
2267:Level of consciousness
2074:mechanical ventilation
1972:Methicillin-resistant
873:10.4244/EIJ-D-20-01296
695:Ultrasound of the Week
400:Abnormal heart rhythms
356:abnormal heart rhythms
315:abnormal heart rhythms
2970:arteriovenous fistula
2784:Bracht–Wachter bodies
1974:Staphylococcus aureus
1034:(16th ed.). The
661:Myocardial infarction
327:Loss of consciousness
2807:Pericardial effusion
2712:Aortic insufficiency
2525:Mitral insufficiency
2507:Graham Steell murmur
1949:Stress hyperglycemia
1790:Organ system failure
1724:Medical specialities
1584:Toxic shock syndrome
352:myocardial contusion
250:altered mental state
3055:Medical emergencies
2740:Austin Flint murmur
2519:Carey Coombs murmur
2312:Related specialties
2272:Acid–base imbalance
2208:ICU scoring systems
2079:Tracheal intubation
1890:Respiratory failure
1885:Acute liver failure
1875:Acute renal failure
1745:Intensive care unit
1729:Respiratory therapy
1167:"Cardiogenic shock"
1100:(Fourth ed.).
808:"Cardiogenic Shock"
656:Shock (circulatory)
548:heart transplantion
406:(slowed heart rate)
262:due to decrease in
79:shortness of breath
3011:Trendelenburg test
2944:pseudohypertension
2922:Right heart strain
2916:pulmonary embolism
2531:Presystolic murmur
2402:circulatory system
2398:Signs and symptoms
2221:Glasgow Coma Scale
2172:Intravenous fluids
2052:Screening cultures
2020:Arterial blood gas
1985:Refeeding syndrome
1902:Neonatal infection
1863:Vasodilatory shock
1838:Distributive shock
1763:Coronary care unit
1661:Vasodilatory shock
1579:Anaphylactic shock
1474:External resources
1287:(10245): 199–212.
1131:Shock: An Overview
961:Marino PL (1998).
764:10.1002/ehf2.13202
530:Medication Therapy
487:Swan–Ganz catheter
481:Swan-Ganz catheter
260:Low blood pressure
240:Signs and symptoms
3037:
3036:
3033:
3032:
2996:Friedreich's sign
2903:Cardarelli's sign
2873:
2872:
2803:Cardiac tamponade
2595:Pulsus bisferiens
2485:Functional murmur
2364:
2363:
2324:Internal medicine
2070:Airway management
2008:
2007:
1848:Obstructive shock
1833:Cardiogenic shock
1669:
1668:
1513:Cardiogenic Shock
1508:
1507:
1038:Companies. 2005.
1007:978-0-936145-02-0
974:978-0-683-05565-8
939:978-0-7817-3548-3
752:ESC Heart Failure
470:
452:
393:electrocardiogram
387:Electrocardiogram
287:due to increased
199:Cardiogenic shock
196:
195:
38:
25:Cardiogenic shock
19:Medical condition
3067:
3023:Pemberton's sign
2884:
2879:Vascular disease
2725:De Musset's sign
2720:Collapsing pulse
2708:
2607:Pulsus alternans
2600:Pulsus bigeminus
2585:Pulsus paradoxus
2400:relating to the
2391:
2384:
2377:
2368:
2085:Cardiac devices
1939:Decubitus ulcers
1853:Neurogenic shock
1787:
1696:
1689:
1682:
1673:
1574:Neurogenic shock
1546:
1539:
1532:
1523:
1401:
1389:
1388:
1378:
1354:
1348:
1347:
1345:
1313:
1307:
1306:
1296:
1272:
1253:
1252:
1242:
1218:
1207:
1206:
1201:. Archived from
1188:
1182:
1181:
1176:. Archived from
1163:
1157:
1156:
1154:
1148:. Archived from
1135:
1126:
1120:
1119:
1114:. Archived from
1091:
1085:
1084:
1079:. Archived from
1060:
1054:
1053:
1048:. Archived from
1026:
1020:
1019:
993:
987:
986:
958:
952:
951:
925:
919:
918:
914:978-1292-17084-8
901:
895:
894:
884:
861:EuroIntervention
852:
846:
845:
835:
803:
786:
785:
775:
758:(2): 1295–1303.
743:
737:
736:
734:
732:
718:
707:
706:
704:
702:
687:
566:descending aorta
472:
471:
454:
453:
433:Echocardiography
428:Echocardiography
308:hyperventilation
272:
40:
39:
22:
3075:
3074:
3070:
3069:
3068:
3066:
3065:
3064:
3040:
3039:
3038:
3029:
3006:Kussmaul's sign
2982:
2897:aortic aneurysm
2869:
2841:Anitschkow cell
2834:rheumatic fever
2821:
2788:
2749:
2730:Duroziez's sign
2697:
2658:
2611:
2561:
2434:
2404:
2395:
2365:
2360:
2307:
2281:
2245:
2202:
2162:Antithrombotics
2140:
2124:Enteral feeding
2106:Kidney dialysis
2056:
2004:
1980:Oxygen toxicity
1958:
1916:
1778:
1733:
1705:
1700:
1670:
1665:
1634:
1606:
1588:
1555:
1550:
1509:
1504:
1503:
1469:
1468:
1412:
1398:
1393:
1392:
1356:
1355:
1351:
1328:(4): CD013002.
1315:
1314:
1310:
1274:
1273:
1256:
1220:
1219:
1210:
1190:
1189:
1185:
1165:
1164:
1160:
1152:
1133:
1128:
1127:
1123:
1112:
1093:
1092:
1088:
1077:
1062:
1061:
1057:
1046:
1028:
1027:
1023:
1008:
995:
994:
990:
975:
960:
959:
955:
940:
927:
926:
922:
915:
903:
902:
898:
854:
853:
849:
805:
804:
789:
745:
744:
740:
730:
728:
720:
719:
710:
700:
698:
689:
688:
679:
674:
652:
644:pulmonary edema
620:
592:
586:
562:
556:
532:
527:
515:
499:
483:
476:
473:
463:
458:
455:
445:
430:
389:
384:
344:
321:Pulmonary edema
278:cutis marmorata
270:
242:
210:cardiomyopathic
99:lightheadedness
75:rapid heartbeat
31:
20:
17:
12:
11:
5:
3073:
3071:
3063:
3062:
3057:
3052:
3050:Heart diseases
3042:
3041:
3035:
3034:
3031:
3030:
3028:
3027:
3026:
3025:
3013:
3008:
3003:
2998:
2992:
2990:
2984:
2983:
2981:
2980:
2979:
2978:
2966:
2961:
2960:
2959:
2947:
2940:
2939:
2938:
2926:
2925:
2924:
2912:
2911:
2910:
2905:
2892:
2890:
2881:
2875:
2874:
2871:
2870:
2868:
2867:
2862:
2861:
2860:
2848:
2843:
2838:
2829:
2827:
2823:
2822:
2820:
2819:
2814:
2798:
2796:
2790:
2789:
2787:
2786:
2781:
2775:Janeway lesion
2772:
2760:
2758:
2751:
2750:
2748:
2747:
2742:
2737:
2732:
2727:
2722:
2716:
2714:
2705:
2699:
2698:
2696:
2695:
2693:Template:Shock
2689:
2684:
2679:
2674:
2668:
2666:
2660:
2659:
2657:
2656:
2654:
2649:
2648:
2647:
2645:Cannon A waves
2637:
2632:
2631:
2630:
2619:
2617:
2613:
2612:
2610:
2609:
2604:
2603:
2602:
2597:
2587:
2582:
2577:
2571:
2569:
2563:
2562:
2560:
2559:
2558:
2557:
2547:
2542:
2537:
2536:
2535:
2534:
2533:
2521:
2516:
2511:
2510:
2509:
2504:
2494:
2493:
2492:
2490:Still's murmur
2487:
2472:
2471:
2470:
2465:
2460:
2455:
2444:
2442:
2436:
2435:
2433:
2432:
2431:
2430:
2420:
2414:
2412:
2406:
2405:
2396:
2394:
2393:
2386:
2379:
2371:
2362:
2361:
2359:
2358:
2353:
2348:
2343:
2342:
2341:
2336:
2331:
2321:
2319:Anesthesiology
2315:
2313:
2309:
2308:
2306:
2305:
2300:
2295:
2289:
2287:
2283:
2282:
2280:
2279:
2274:
2269:
2264:
2259:
2253:
2251:
2247:
2246:
2244:
2243:
2238:
2233:
2228:
2223:
2218:
2216:APACHE II
2212:
2210:
2204:
2203:
2201:
2200:
2195:
2189:
2184:
2179:
2174:
2169:
2164:
2159:
2154:
2148:
2146:
2142:
2141:
2139:
2138:
2133:
2132:
2131:
2126:
2118:
2113:
2108:
2103:
2098:
2097:
2096:
2091:
2083:
2082:
2081:
2066:
2064:
2058:
2057:
2055:
2054:
2049:
2047:Blood cultures
2044:
2043:
2042:
2037:
2032:
2022:
2016:
2014:
2010:
2009:
2006:
2005:
2003:
2002:
1997:
1992:
1987:
1982:
1977:
1968:
1966:
1960:
1959:
1957:
1956:
1951:
1946:
1941:
1936:
1931:
1924:
1922:
1918:
1917:
1915:
1914:
1909:
1904:
1898:
1897:
1892:
1887:
1882:
1877:
1872:
1866:
1865:
1860:
1855:
1850:
1845:
1840:
1835:
1830:
1823:
1822:
1817:
1812:
1807:
1802:
1797:
1796:Shock sequence
1793:
1791:
1784:
1780:
1779:
1777:
1776:
1771:
1766:
1760:
1754:
1748:
1741:
1739:
1735:
1734:
1732:
1731:
1726:
1721:
1716:
1714:Health science
1710:
1707:
1706:
1701:
1699:
1698:
1691:
1684:
1676:
1667:
1666:
1664:
1663:
1658:
1653:
1648:
1642:
1640:
1636:
1635:
1633:
1632:
1631:
1630:
1620:
1614:
1612:
1608:
1607:
1605:
1604:
1598:
1596:
1590:
1589:
1587:
1586:
1581:
1576:
1571:
1565:
1563:
1557:
1556:
1551:
1549:
1548:
1541:
1534:
1526:
1520:
1519:
1506:
1505:
1502:
1501:
1490:
1478:
1477:
1475:
1471:
1470:
1467:
1466:
1455:
1444:
1429:
1413:
1408:
1407:
1405:
1404:Classification
1397:
1396:External links
1394:
1391:
1390:
1369:(6): 654–662.
1349:
1308:
1254:
1233:(6): e50–e68.
1208:
1205:on 2017-07-27.
1183:
1180:on 2017-07-23.
1158:
1155:on 2017-06-22.
1121:
1118:on 2006-09-23.
1110:
1086:
1083:on 2010-06-16.
1075:
1055:
1052:on 2012-08-04.
1044:
1021:
1006:
988:
973:
953:
938:
920:
913:
896:
867:(6): 451–465.
847:
818:(8): e011991.
787:
738:
708:
697:. 30 June 2014
676:
675:
673:
670:
669:
668:
663:
658:
651:
648:
633:cardiac arrest
619:
616:
596:left ventricle
588:Main article:
585:
582:
558:Main article:
555:
552:
531:
528:
526:
523:
514:
511:
498:
495:
482:
479:
478:
477:
474:
461:
459:
456:
443:
429:
426:
425:
424:
422:cardiomyopathy
418:
407:
388:
385:
383:
380:
360:cardiomyopathy
343:
340:
339:
338:
324:
318:
311:
301:
298:
292:
281:
274:
267:
264:cardiac output
257:
241:
238:
214:a heart attack
194:
193:
189:
183:
182:
173:
167:
166:
152:
148:
147:
144:cardiac arrest
116:
110:
109:
68:
62:
61:
56:
50:
49:
42:
41:
27:
26:
18:
15:
13:
10:
9:
6:
4:
3:
2:
3072:
3061:
3058:
3056:
3053:
3051:
3048:
3047:
3045:
3024:
3021:
3020:
3019:
3018:
3014:
3012:
3009:
3007:
3004:
3002:
3001:Caput medusae
2999:
2997:
2994:
2993:
2991:
2989:
2985:
2977:
2974:
2973:
2972:
2971:
2967:
2965:
2962:
2958:
2957:Lines of Zahn
2955:
2954:
2953:
2952:
2948:
2946:
2945:
2941:
2937:
2934:
2933:
2932:
2931:
2927:
2923:
2920:
2919:
2918:
2917:
2913:
2909:
2908:Oliver's sign
2906:
2904:
2901:
2900:
2899:
2898:
2894:
2893:
2891:
2889:
2885:
2882:
2880:
2876:
2866:
2863:
2859:
2856:
2855:
2854:
2853:
2849:
2847:
2844:
2842:
2839:
2837:
2835:
2831:
2830:
2828:
2824:
2818:
2815:
2813:
2810:
2808:
2804:
2800:
2799:
2797:
2795:
2791:
2785:
2782:
2780:
2776:
2773:
2771:
2768:
2766:
2762:
2761:
2759:
2757:
2752:
2746:
2743:
2741:
2738:
2736:
2735:MĂĽller's sign
2733:
2731:
2728:
2726:
2723:
2721:
2718:
2717:
2715:
2713:
2709:
2706:
2704:
2700:
2694:
2690:
2688:
2685:
2683:
2680:
2678:
2675:
2673:
2670:
2669:
2667:
2665:
2661:
2655:
2653:
2650:
2646:
2643:
2642:
2641:
2638:
2636:
2635:CĹ“ur en sabot
2633:
2629:
2626:
2625:
2624:
2621:
2620:
2618:
2614:
2608:
2605:
2601:
2598:
2596:
2593:
2592:
2591:
2588:
2586:
2583:
2581:
2578:
2576:
2573:
2572:
2570:
2568:
2564:
2556:
2553:
2552:
2551:
2548:
2546:
2543:
2541:
2538:
2532:
2529:
2528:
2527:
2526:
2522:
2520:
2517:
2515:
2512:
2508:
2505:
2503:
2500:
2499:
2498:
2495:
2491:
2488:
2486:
2483:
2482:
2481:
2478:
2477:
2476:
2473:
2469:
2468:Gallop rhythm
2466:
2464:
2461:
2459:
2456:
2454:
2451:
2450:
2449:
2446:
2445:
2443:
2441:
2437:
2429:
2428:Levine's sign
2426:
2425:
2424:
2421:
2419:
2418:Referred pain
2416:
2415:
2413:
2411:
2407:
2403:
2399:
2392:
2387:
2385:
2380:
2378:
2373:
2372:
2369:
2357:
2354:
2352:
2349:
2347:
2344:
2340:
2337:
2335:
2332:
2330:
2327:
2326:
2325:
2322:
2320:
2317:
2316:
2314:
2310:
2304:
2301:
2299:
2296:
2294:
2291:
2290:
2288:
2286:Organisations
2284:
2278:
2275:
2273:
2270:
2268:
2265:
2263:
2260:
2258:
2255:
2254:
2252:
2248:
2242:
2239:
2237:
2236:SAPS III
2234:
2232:
2229:
2227:
2224:
2222:
2219:
2217:
2214:
2213:
2211:
2209:
2205:
2199:
2196:
2193:
2190:
2188:
2185:
2183:
2180:
2178:
2175:
2173:
2170:
2168:
2165:
2163:
2160:
2158:
2155:
2153:
2150:
2149:
2147:
2143:
2137:
2134:
2130:
2127:
2125:
2122:
2121:
2119:
2117:
2114:
2112:
2109:
2107:
2104:
2102:
2099:
2095:
2092:
2090:
2087:
2086:
2084:
2080:
2077:
2076:
2075:
2071:
2068:
2067:
2065:
2063:
2059:
2053:
2050:
2048:
2045:
2041:
2038:
2036:
2033:
2031:
2030:Arterial line
2028:
2027:
2026:
2023:
2021:
2018:
2017:
2015:
2011:
2001:
1998:
1996:
1993:
1991:
1988:
1986:
1983:
1981:
1978:
1976:
1975:
1970:
1969:
1967:
1965:
1961:
1955:
1952:
1950:
1947:
1945:
1942:
1940:
1937:
1935:
1932:
1929:
1926:
1925:
1923:
1921:Complications
1919:
1913:
1910:
1908:
1905:
1903:
1900:
1899:
1896:
1893:
1891:
1888:
1886:
1883:
1881:
1878:
1876:
1873:
1871:
1870:Organ failure
1868:
1867:
1864:
1861:
1859:
1856:
1854:
1851:
1849:
1846:
1844:
1841:
1839:
1836:
1834:
1831:
1829:
1825:
1824:
1821:
1818:
1816:
1813:
1811:
1810:Severe sepsis
1808:
1806:
1803:
1801:
1798:
1795:
1794:
1792:
1788:
1785:
1781:
1775:
1772:
1770:
1767:
1764:
1761:
1758:
1755:
1752:
1749:
1746:
1743:
1742:
1740:
1738:General terms
1736:
1730:
1727:
1725:
1722:
1720:
1717:
1715:
1712:
1711:
1708:
1704:
1697:
1692:
1690:
1685:
1683:
1678:
1677:
1674:
1662:
1659:
1657:
1656:Cryptic shock
1654:
1652:
1649:
1647:
1644:
1643:
1641:
1637:
1629:
1628:Osmotic shock
1626:
1625:
1624:
1621:
1619:
1616:
1615:
1613:
1609:
1603:
1600:
1599:
1597:
1595:
1591:
1585:
1582:
1580:
1577:
1575:
1572:
1570:
1567:
1566:
1564:
1562:
1558:
1554:
1547:
1542:
1540:
1535:
1533:
1528:
1527:
1524:
1518:
1514:
1511:
1510:
1500:
1496:
1495:
1491:
1489:
1485:
1484:
1480:
1479:
1476:
1472:
1465:
1461:
1460:
1456:
1454:
1450:
1449:
1445:
1443:
1439:
1438:
1434:
1430:
1428:
1424:
1423:
1419:
1415:
1414:
1411:
1406:
1402:
1395:
1386:
1382:
1377:
1372:
1368:
1364:
1360:
1353:
1350:
1344:
1339:
1335:
1331:
1327:
1323:
1319:
1312:
1309:
1304:
1300:
1295:
1290:
1286:
1282:
1278:
1271:
1269:
1267:
1265:
1263:
1261:
1259:
1255:
1250:
1246:
1241:
1236:
1232:
1228:
1224:
1217:
1215:
1213:
1209:
1204:
1200:
1199:
1193:
1187:
1184:
1179:
1175:
1174:
1168:
1162:
1159:
1151:
1147:
1143:
1139:
1132:
1125:
1122:
1117:
1113:
1111:0-19-262922-0
1107:
1103:
1099:
1098:
1090:
1087:
1082:
1078:
1076:0-7216-9652-X
1072:
1068:
1067:
1059:
1056:
1051:
1047:
1045:0-07-140235-7
1041:
1037:
1033:
1032:
1025:
1022:
1017:
1013:
1009:
1003:
999:
992:
989:
984:
980:
976:
970:
966:
965:
957:
954:
949:
945:
941:
935:
931:
924:
921:
916:
910:
906:
900:
897:
892:
888:
883:
878:
874:
870:
866:
862:
858:
851:
848:
843:
839:
834:
829:
825:
821:
817:
813:
809:
802:
800:
798:
796:
794:
792:
788:
783:
779:
774:
769:
765:
761:
757:
753:
749:
742:
739:
727:
723:
717:
715:
713:
709:
696:
692:
686:
684:
682:
678:
671:
667:
664:
662:
659:
657:
654:
653:
649:
647:
645:
641:
636:
634:
628:
626:
617:
615:
613:
612:aortic valves
609:
605:
600:
597:
591:
583:
581:
577:
575:
571:
567:
561:
553:
551:
549:
543:
541:
537:
529:
524:
522:
520:
519:cardiac index
513:Cardiac index
512:
510:
508:
504:
496:
494:
492:
488:
480:
460:
442:
440:
438:
434:
427:
423:
419:
416:
412:
408:
405:
401:
398:
397:
396:
394:
386:
381:
379:
377:
376:heart failure
373:
369:
365:
361:
357:
353:
349:
341:
336:
332:
328:
325:
322:
319:
316:
312:
309:
305:
302:
299:
296:
293:
290:
286:
285:jugular veins
282:
279:
275:
268:
265:
261:
258:
255:
251:
247:
246:
245:
239:
237:
233:
231:
225:
222:
217:
215:
211:
206:
204:
200:
190:
188:
184:
181:
177:
176:Heart failure
174:
172:
168:
164:
160:
156:
153:
149:
145:
141:
137:
136:cor pulmonale
133:
129:
125:
121:
120:heart failure
117:
115:
114:Complications
111:
108:
104:
100:
96:
92:
88:
84:
80:
76:
72:
69:
67:
63:
60:
57:
55:
51:
48:
43:
28:
23:
3015:
2968:
2964:Adson's sign
2949:
2942:
2936:Allen's test
2928:
2914:
2895:
2850:
2846:Aschoff body
2832:
2817:Ewart's sign
2812:Beck's triad
2801:
2779:Osler's node
2765:endocarditis
2763:
2745:Mayne's sign
2691:See further
2687:Distributive
2671:
2623:Palpitations
2589:
2523:
2475:Heart murmur
2448:Heart sounds
2440:Auscultation
2356:Traumatology
2257:Hemodynamics
2231:SAPS II
2198:Vasopressors
2116:Induced coma
1973:
1964:Iatrogenesis
1954:Stress ulcer
1858:Spinal shock
1832:
1815:Septic shock
1651:Spinal shock
1645:
1569:Septic shock
1561:Distributive
1492:
1481:
1457:
1446:
1431:
1416:
1366:
1362:
1352:
1325:
1321:
1311:
1284:
1280:
1230:
1226:
1203:the original
1195:
1186:
1178:the original
1170:
1161:
1150:the original
1137:
1124:
1116:the original
1096:
1089:
1081:the original
1065:
1058:
1050:the original
1030:
1024:
997:
991:
964:The ICU book
963:
956:
929:
923:
904:
899:
864:
860:
850:
815:
811:
755:
751:
741:
729:. Retrieved
725:
699:. Retrieved
694:
640:air embolism
637:
629:
621:
601:
593:
578:
563:
544:
533:
516:
500:
491:hemodynamics
484:
431:
390:
348:heart muscle
345:
310:and hypoxia.
243:
234:
226:
218:
207:
198:
197:
180:hypertension
171:Risk factors
163:endocarditis
155:Heart attack
2794:Pericardium
2770:Roth's spot
2756:endocardium
2682:Hypovolemic
2677:Obstructive
2672:Cardiogenic
2580:Bradycardia
2575:Tachycardia
2545:Heart click
2339:Pulmonology
2262:Hypotension
2157:Antibiotics
2000:Dialytrauma
1843:Anaphylaxis
1646:Cardiogenic
1623:Hypovolemia
1594:Obstructive
1483:MedlinePlus
1227:Circulation
1144:, Florida:
1036:McGraw-Hill
726:Mayo Clinic
404:bradycardia
374:), causing
372:Henry's law
364:heart valve
178:, old age,
159:myocarditis
128:arrhythmias
124:heart block
83:hypotension
47:myocarditis
3044:Categories
2652:Hyperaemia
2514:Continuous
2410:Chest pain
2346:Pediatrics
2329:Cardiology
2250:Physiology
2152:Analgesics
2101:Chest tube
1930:/ myopathy
1907:Polytrauma
1783:Conditions
1618:Hemorrhage
1611:Low-volume
1459:DiseasesDB
1140:(Report).
672:References
536:dobutamine
415:non-STEMIs
402:, such as
283:Distended
126:, serious
91:chest pain
59:Cardiology
2628:Apex beat
2497:Diastolic
2334:Neurology
2187:Sedatives
2167:Inotropes
2013:Diagnosis
1517:eMedicine
1494:eMedicine
1198:Hong Kong
1173:Hong Kong
983:300112092
604:hemolysis
540:milrinone
525:Treatment
507:diagnosis
420:Signs of
382:Diagnosis
187:Prognosis
95:dizziness
54:Specialty
2951:thrombus
2888:Arterial
2480:Systolic
2453:Split S2
2025:Catheter
1944:Fungemia
1719:Medicine
1385:30765031
1303:32682486
1249:35862152
1016:48632566
948:53868338
891:34413010
842:30947630
782:33605565
650:See also
570:diastole
295:Oliguria
230:dialysis
130:such as
87:sweating
66:Symptoms
2590:doubled
2555:carotid
2351:Surgery
1499:med/285
1453:D012770
1343:6494568
1142:Orlando
882:9724885
833:6507212
773:8006704
574:systole
517:If the
306:due to
304:Fatigue
254:hypoxia
146:, death
122:and/or
71:Fatigue
2988:Venous
2858:J wave
2754:Other
2423:Angina
1826:Other
1805:Sepsis
1759:(PICU)
1753:(NICU)
1488:000185
1442:785.51
1383:
1340:
1301:
1281:Lancet
1247:
1108:
1073:
1042:
1014:
1004:
981:
971:
946:
936:
911:
889:
879:
840:
830:
780:
770:
731:22 May
701:27 May
666:Angina
608:mitral
503:biopsy
497:Biopsy
342:Causes
333:, and
151:Causes
103:nausea
2826:Other
2664:Shock
2616:Other
2567:Pulse
2550:Bruit
2194:drugs
2145:Drugs
1828:shock
1765:(CCU)
1747:(ICU)
1639:Other
1553:Shock
1464:29216
1427:R57.0
1153:(PDF)
1134:(PDF)
411:STEMI
203:heart
2241:SOFA
2226:PIM2
2072:and
1912:Coma
1800:SIRS
1448:MeSH
1437:9-CM
1381:PMID
1326:2018
1299:PMID
1245:PMID
1106:ISBN
1071:ISBN
1040:ISBN
1012:OCLC
1002:ISBN
979:OCLC
969:ISBN
944:OCLC
934:ISBN
909:ISBN
887:PMID
838:PMID
778:PMID
733:2020
703:2017
485:The
331:coma
2852:EKG
1515:by
1433:ICD
1418:ICD
1371:doi
1338:PMC
1330:doi
1289:doi
1285:396
1235:doi
1231:146
877:PMC
869:doi
828:PMC
820:doi
768:PMC
760:doi
610:or
538:or
391:An
105:,
97:or
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2463:S4
2458:S3
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