How is cardiogenic shock diagnosed?

If the reason for the shock is that the heart isn't pumping strongly enough, then the diagnosis is cardiogenic shock.

Tests that are useful in diagnosing cardiogenic shock include:

  • Blood pressure: Using a simple blood pressure sleeve and stethoscope, doctors can check to see if a person has very low blood pressure, the most common sign of shock. Very low blood pressure also can have less serious causes, including simple fainting and side effects of medicines, such as medicines that treat high blood pressure.
  • EKG (electrocardiogram): This test detects and records the electrical activity of the heart, measuring the rate and regularity of the heartbeat. Doctors use EKG to diagnose severe heart attack and monitor your heart's condition.
  • Chest x-ray: A chest x-ray shows whether the heart is enlarged or whether there is fluid in the lungs, which can be signs of cardiogenic shock.
  • Echocardiography: This test uses sound waves to create a moving picture of your heart. Echocardiography provides information about the size and shape of your heart and how well your heart chambers and valves are working. The test also can identify areas of heart muscle that aren't contracting normally. Not enough blood is flowing to these areas.
  • Coronary angiography: This test is an x-ray exam of the heart and blood vessels. The doctor passes a catheter through an artery in your leg or arm to your heart. The catheter can measure the pressure inside the various chambers of your heart. A dye that can be seen on x-ray is injected into the blood through the tip of the catheter. The dye lets the doctor study the flow of blood through the heart and blood vessels and see any blockages that exist.

Certain blood tests also are used to diagnose cardiogenic shock, including:

  • Arterial blood gas measurement
  • Cardiac enzymes
  • Tests that measure the function of various organs, such as the kidneys and liver

This answer from the National Heart, Lung and Blood Institute has been reviewed and/or edited by Dr. William D. Knopf.

Usually, the general state of shock is diagnosed first, based on the following tests:

  • Blood pressure, since shock is categorized by a marked decrease in blood pressure.
  • Electrocardiogram (EKG), to check for abnormal heart rhythms and quickened heartbeat./li>

Once shock has been diagnosed, physicians will look into the specific type of shock it is in order to treat it properly. Some examples of diagnostic tests for cardiogenic shock are:

  • Medical imaging, such as angiograms, echocardiograms, and chest X-rays. Each of these tests determines whether the heart is enlarged or damaged, two conditions that can cause cardiogenic shock.
  • Blood tests. Physicians can determine whether your internal organs are working properly and whether enough oxygen is present in your blood, based on various blood tests.

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