Tests and diagnosisBy Mayo Clinic staff
Cardiogenic shock is usually diagnosed in an emergency setting. Doctors will check for signs and symptoms of shock, and will then perform additional tests to find out what's causing your condition. Tests to diagnose cardiogenic shock include:
- Blood pressure measurement. People in shock often have very low blood pressure readings. If the person in shock is brought to the hospital by ambulance, blood pressure will be measured before he or she arrives at the hospital.
- Electrocardiogram (ECG). This is the first test done to diagnose a heart attack. It's often done while you're being asked questions about your symptoms. This test records the electrical activity of your heart via electrodes attached to your skin. Impulses are recorded as "waves" displayed on a monitor or printed on paper. Because injured heart muscle doesn't conduct electrical impulses normally, the ECG may show that a heart attack has occurred or is in progress.
- Chest X-ray. An X-ray image of your chest allows your doctor to check the size and shape of your heart and its blood vessels.
- Blood tests. Blood will be drawn to see if your kidneys or liver might be damaged, to look for signs of an infection in your heart, and to see if you've had a heart attack. Another type of blood test (arterial blood gas) may also be used to determine how much oxygen is present in the blood.
- Echocardiogram. This test uses sound waves to produce an image of your heart. During an echocardiogram, sound waves are directed at your heart from a wand-like device (transducer) held on your chest. The sound waves bounce off your heart and are reflected back through your chest wall and processed electronically to provide video images of your heart. An echocardiogram can help identify whether an area of your heart has been damaged by a heart attack and isn't pumping normally.
Coronary catheterization (angiogram). This test can show if your coronary arteries are narrowed or blocked. A liquid dye is injected into the arteries of your heart through a long, thin tube (catheter) that's pushed through an artery, usually in your leg, to the arteries in your heart. As the dye fills your arteries, the arteries become visible on X-ray, revealing areas of blockage.
Additionally, while the catheter is in position, your doctor may treat the blockage by performing an angioplasty. Angioplasty uses tiny balloons threaded through a blood vessel and into a coronary artery to widen the blocked area. In most cases, a mesh tube (stent) is also placed inside the artery to hold it open more widely and prevent re-narrowing in the future.
- Cardiogenic shock. National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/health/dci/Diseases/shock/shock_what.html. Accessed July 27, 2011.
- Reynolds HR, et al. Cardiogenic shock: Current concepts and improving outcomes. Circulation. 2008;117:686.
- Goldberg RJ, et al. Thirty-year trends (1975 to 2005) in the magnitude of, management of, and hospital death rates associated with cardiogenic shock in patients with acute myocardial infarction. Circulation. 2009;119:1211.
- Menon V, et al. Prognosis and treatment of cardiogenic shock complicating acute myocardial infarction. http://www.uptodate.com/home/index.html. Accessed July 27, 2011.
- Hochman JS, et al. Clinical manifestations and diagnosis of cardiogenic shock. http://www.uptodate.com/home/index.html. Accessed July 27, 2011.