Common manifestations of cardiogenic shock is very characteristic. The patient is adynamic, sharply weakened, is low-lying, the pain does not complain, responds to questions with difficulty, often falls in a catatonic stuporous state. Sometimes there is momentary agitation. Possible deeper the oppression, confusion, darkness and even loss of consciousness (15 – 30 min). The face is pale with a gray tint, the lips and mucous membranes blue, extremities cold, integuments acquire a “marble” pattern, covered by a cold sticky sweat, veins pale.
One of the main signs of cardiogenic shock is a catastrophic drop in blood pressure: normotonikov systolic pressure falls below 80 mm Hg, in hypertensive patients – less than 90 mm Hg. In half of the cases the systolic pressure exceeds 60 mm Hg in Approximately 1/3 of patients with a blood pressure of 60/40 sound method is not defined by any single deaf hear sounds at 30 and 20 mm Hg. Pulse pressure, if/is given to measure the diastolic is less than 20 mm Hg.
Blood pressure 60/40 – is a sign of Cardiogenic shock
Pulse small filling, often more than 100-120 beats per minute, is often preserved sinus rhythm. By reducing blood pressure to 60/40 mm Hg, pulse becomes filiform; lower blood pressure the pulse ceases to be palpable. Heart tones deaf, sometimes you can capture III the tone or melody of the protodiastolic gallop rhythm. The breathing is frequent and shallow (25 – 35 in 1 min); on the background of the fall in blood pressure usually increase congestion in the lungs until the swelling. The liver is not increased. Greatly disturbed kidney function – decreased urine output (less than 30 ml/HR), anuria occurs. This inevitably leads to acute uremia and hyperkalemia.
Against the background of cardiogenic shock, even briefly, there may be various additional complications. Thrombosis of large arteries, heart attacks, lung, spleen, skin necrosis, hemorrhage.
Depending on the degree of reduction in blood pressure, the severity of peripheral disorders, response to treatment distinguish cardiogenic shock moderate and severe. In cardiogenic shock of moderate severity may be some Pressor reaction in response to therapeutic effects. Soon, however, arterial pressure increased to 80 – 90 mm Hg, again decreasing and increasing peripheral manifestations of shock. Patients with cardiogenic shock severe forms practically do not respond to medical therapy. About 70% of patients with cardiogenic shock die within 1 day, often within 4 to 6 h from the moment of occurrence of this complication; rarely cardiogenic shock is delayed for 2 – 3 days. Survive cardiogenic shock is only about 10% of patients. Some of them die later from heart failure.