Cardiogenic Shock: Introduction (Nursing)

00:00 Hi, I'm Prof. Lawes. And this is a continuation of our shock series.

00:05 Now, in this one, we're going to specifically look at cardiogenic shock.

00:09 Remember, there are multiple types of shock, including cardiogenic, hypovolemic, anaphylactic, septic, and neurogenic.

00:17 And I just want to give you a heads up.

00:19 I go into a lot more detail about the phases and stages in the hypovolemic shock video.

00:25 This video, I'm just going to talk to you about how cardiogenic shock is different.

00:29 Because remember, shock is not getting enough oxygen to the body cells, right, to meet their metabolic needs.

00:37 The word before shock is just the underlying cause, or the reason that's not able to deliver oxygen to the tissues.

00:44 Okay, so this is cardiogenic.

00:46 We're going to talk about the heart problems.

00:49 So here we have your heart.

00:51 Now, before we talk about cardiogenic shock, make sure you orient yourself.

00:55 You see the blue side, that's the right side of the heart.

00:59 That's the right atrium, the right ventricle going over to the lungs.

01:03 On the red side of the heart, that's the left atrium and the left ventricle.

01:09 Now, since we're talking about cardiogenic shock, this heart has been damaged.

01:14 One example, that might be a myocardial infarction.

01:18 So, look at the wall of that heart. Do you see the dark spot? That represents damage to that heart tissue right there.

01:26 That was deprived of oxygen.

01:28 And because the heart muscle right there was deprived of oxygen, in a myocardial infarction, the tissue died.

01:35 That when the tissue dies, it doesn't send electrical signals through it anymore.

01:40 And it sure doesn't contract and expand like we need it to, to work as an efficient pump.

01:45 Now, that left ventricle is really important, because it pushes blood out to the rest of the body.

01:52 So, the heart has been insulted of a myocardial infarction, which means you have dead tissue in the left ventricular wall, to the point where the body is starting to be affected.

02:04 Because if the heart can't pump, it can't deliver enough oxygen.

02:09 And we know that shock is an inadequate amount of oxygen being delivered to the tissues, the cells in the tissue.

02:17 And you saw that little arrows shooting through the heart.

02:20 See how thin it is? Remember, that's our way of reminding you that when a heart is hurt, when his head an insult, like this myocardial infarction, and dead tissue, you see that arrow is just tiny, to remind you that there's not enough blood being pushed out of the heart because of the damage to the wall.

02:42 Now, what are some other things that can cause cardiogenic shock? Well, you see, we have a picture of myocarditis.

02:49 Remember, that's an inflammatory process.

02:51 You've got arrhythmias.

02:53 Now, take a look at that arrhythmia.

02:56 You see how there's a long space in between? Well, when you don't have that QRS complex, which is the ventricle contracting.

03:04 That means you're going to have less blood efficiently delivered.

03:08 Now, it could take a pretty significant arrhythmia for this to happen. But just keep that in mind.

03:13 We've talked about heart attack already, and if the valves aren't working.

03:18 Okay, so these four things here, these are four things that make your heart not as effective as a pump.

03:26 When the heart can't pump, it doesn't deliver enough oxygenated blood to the tissues.

03:31 That's why we end up in shock.

03:33 So, myocarditis, inflammation. Heart is an ineffective pump.

03:37 Arrhythmias, ineffective pump.

03:40 Myocardial infarction, dead tissue, ineffective pump.

03:43 Valvular insufficiency, that means the valves aren't working.

03:47 Ineffective pump, because blood doesn't move through the heart in the one way direction that it was intended to move.