Table 1.
Etiologies of cardiogenic shock.
Acute coronary syndrome
|
| Acute or chronic heart failure |
Acute heart failure
|
| Post-cardiotomy |
Valvular disease
|
| Uncontrolled arrhythmia |
| Cardiac tamponade |
| Myocardial contusion |
| Left ventricular outflow obstruction |
Acute pulmonary embolism
|
Table 2.
Inotropic and vasopressor drugs commonly used in cardiogenic shock.
| DRUG | PRIMARY MECHANISM | DOSING |
|---|---|---|
| Dobutamine | β1 agonist | 2.5–20 mcg/kg/min |
| Milrinone | Phosphodiesterase 3 inhibitor | 0.125–0.5 mcg/kg/min |
| Epinephrine | Mixed α,β agonist | 0.01–1 mcg/kg/min |
| Norepinephrine | Mixed α,β agonist (α> β) | 0.01–1 mcg/kg/min |
| Vasopressin | V1 receptor in vascular smooth muscle | 0.02–0.04 units/min |
| Dopamine | Dopamine at low dose; increasing β and α agonist at higher doses | 0.5–20 mcg/kg/min |