Cardiogenic Shock

Cardiogenic shock is the failure of the heart itself as a pump. A large infarction — most often anterior — destroys enough myocardium that the left ventricle can no longer eject its contents. Cardiac output falls, so the tissues are underperfused; at the same time blood backs up behind the failing ventricle, so pulmonary pressures rise and the lungs fill. That combination of low forward flow and high filling pressure is the whole disease, and it is what makes cardiogenic shock behave in the opposite direction from hypovolemic and distributive shock.