‘Cardiogenic Shock Team’ Provides Urgent Screening, Treatment of Serious Heart Condition

The Cardiogenic Shock Team at Miami Cardiac & Vascular Institute and Baptist Hospital is ready around-the-clock to assist with the immediate evaluation and management of “cardiogenic shock” — a life-threatening condition in which the heart is unable to pump sufficient blood throughout the body.

Cardiogenic shock most often occurs soon after a heartattack, but it can also occur after heart surgery or with an acute illness suchas cardiomyopathy, which is a weakening of the heart muscle. Patients with thiscondition must be treated immediately to restore perfusion, which refers to theproper flow of blood to the body’s organs, and prevent further deterioration sothat the heart can recover.

Currently there are no routine screening tests forcardiogenic shock. Tests are usually done after you have been admitted to ahospital for a possible heart attack or symptoms of cardiogenic shock. If theheart is not pumping strongly enough, then the diagnosis likely will becardiogenic shock.

“The initial step involves getting the patient’s history and doing a physical exam — then the patient undergoes a screening electrocardiogram,” explains Sandra Chaparro, M.D., cardiologist and director of the Advanced Heart Failure program at Miami Cardiac & Vascular Institute. “Blood tests will help evaluate the severity of the cardiogenic shock.”

If the patient needs emergency support, such as in the caseof a heart attack, they are treated initially in the Emergency Department, Dr.Chaparro adds. In the case cardiogenic shock, “the patient will betransferred to the cardiac catheterization to open the vessels in case of anacute myocardial infarction (heart attack) and to implant a mechanicaltemporary support device if needed,” says Dr. Chaparro.

Dr. Chaparro leads the Cardiogenic Shock Team, assisted by Joseph T. McGinn, M.D., chief of cardiac surgery at Miami Cardiac & Vascular Institute; Marcus St. John, M.D., medical director of the Cardiac Catheterization Lab at Baptist Hospital; and Ramon Lloret, M.D., medical director of Clinical Cardiology.

“The idea is that with a single phone call a group of  four or so specialists (the shock team) can bebrought together to discuss the care of a patient in cardiogenic shock,” saysDr. St. John.

Creating the ‘Shock Team’

Dr. St. John recounts how the idea for thisteam was launched. In 2018, a Miami Cardiac & Vascular Institute committeeof doctors and administrators from Baptist Hospital and South Miami Hospital developedan algorithm to try to standardize and optimize the management of a patientwith a heart attack complicated by cardiogenic shock, he explains.

“This year, Dr Sandra Chaparro, who is an advanced heart failure specialist and new addition to the cardiology group, recognized an opportunity to further improve the process and utilization of the algorithm by having a shock team,” said Dr. St. John. “With her input, as well as input from Dr. McGinn and many of the interventional cardiologists, a shock team process was put in place.”  

Treatment for cardiogenic shock can include medicines, heartprocedures, and medical devices to support or restore blood flow in the bodyand prevent organ damage. Because this is a serious medical condition affectingmultiple body organs, a team of medical specialists usually provides care.

A heart attack is the most common cause because it candamage the heart’s structure in different ways. Less often, a problem elsewherein the body blocks blood flow coming into or out of the heart and leads tocardiogenic shock.

You can reduce your risk for cardiogenic shock by adoptingheart-healthy lifestyle changes, including proper diet and regular exercise, tohelp prevent heart disease, or underlying risk factors such as high bloodpressure, high cholesterol or diabetes. If you already have heart disease oranother heart condition, follow your doctor’s instructions about taking care ofyour health, getting regular check-ups, and taking prescribed medicines to treathigh blood pressure or other conditions.

Signs and Symptoms of Cardiogenic Shock

The most common signs of cardiogenic shock are: Low bloodpressure, which can make you feel dizzy, confused and nauseous

Weak or irregular pulse. Adds Dr. Chaparro: “Sometimesthe symptoms can be unspecific and vague such as weakness, fatigue, nausea,vomiting, or abdominal pain.”

Other signs and symptoms of cardiogenic shock mayinclude:

  • Breathing problems, including rapid breathingand severe shortness of breath
  • Bulging of large veins in the neck
  • Clammy skin
  • Cold hands and feet
  • Loss of consciousness
  • Swelling of feet
  • Urinating much less than usual or not at all
  • Any of these alone is not likely to be a sign orsymptom of cardiogenic shock.

Healthcare that Cares

With internationally renowned centers of excellence, 12 hospitals, more than 27,000 employees, 4,000 physicians and 200 outpatient centers, urgent care facilities and physician practices spanning across Miami-Dade, Monroe, Broward and Palm Beach counties, Baptist Health is an anchor institution of the South Florida communities we serve.

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