Essay Sample on Cardiogenic Shock

Introduction

A cardiogenic shock results from the body's inability of the heart to pump enough blood required by the body. In most cases, the condition results from complications of the heart muscles making it difficult for the heart to pump blood. The complication of these muscles could be caused by a heart attack that affects the heart major pumping chamber. It is estimated that about 70-90 percent of these deaths are attributed to lack of necessary specialized treatment of this condition.

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In this case, the patient was experiencing heart failure-related symptoms, and he was getting worse based on the signs. Some of these symptoms included the patient's chest constant aching which spread later to his left arm. The change in the patient's blood pressure levels is also alarming and requires to be addressed (Amsterdam et al., 2014). Normal blood pressure should be less than 120/80 and more than 140/90. The initial tests showed his blood pressure was 108/73 and it later changed to 87/53 an indication it was rising. The patient's SP02 level was 88% way below compared to the healthy rate which should be at least 94% (Bergum, Haugen, Nordseth, Mjolstad & Skogvoll, 2015). These results can prove to be very risky since the percentage of the patient's oxygenated hemoglobin is lower than the amount of the total hemoglobin in his body. Initially, in the first test, the levels were 95%, and later on, it was recorded to decrease to 88%, and this shows his condition was worsening.

Symptoms of Cardiogenic Shock

The patient could be at risk of incurring rapid breathing, loss of consciousness, low blood pressure and rapid heartbeat (Cowie et al., 2015). Lastly, the patient's respiratory rate indicated the patient's condition needed to be addressed immediately. Initial tests showed his rate was twenty-one per minute while the next tests showed beats per minute. This is normal although there was an increase in the number of beats based on the tests and it is clear the patient required condition needed to be checked. Fatigue is one of the symptoms associated with a cardiogenic shock, and the patient's lethargic condition should raise concerns. This is because the tissues were not getting oxygenated blood which is crucial for the respiration. Lethargic state of the patient could have resulted from the tiredness of the body that affected the normal functioning of the body (Riley & Beattie, 2017).

Based on these tests, it is clear the patients' condition is worsening, and it is crucial to give him immediate medical attention. Based on the clinical review, it is clear there is a need for rapid response to stabilize the patient's condition.

Situation I am calling to report the current status of one of my patients. Based on the recent tests I have conducted on him, it is clear that his condition is worsening. This is based on the patient's respiratory rate, peripheral capillary oxygen saturation, blood pressure and the pains he is experiencing. I believe he is having a cardiogenic shock and requires quick medical attention.

Background

The patient has been experiencing chest pains over the past few years. However, the pains had ended, and recently he started experiencing the chest pains. However, these pains have now spread to his left arm and this time around the pains are severe. The patient has also been experiencing dizziness and experiences shortness of breath. His respiratory rate has increased from twenty-one times per beat to twenty-five beats per minute. His blood sugar levels have risen from 108/73 to 87/53 and lastly; his oxygen levels decreased from 95% to 88%.

Assessment I performed various tests on the patient based on the A-G physical assessment I made multiple observations. Using the Echodiogram, it was clear the heart sounds of the patient's rhythm were irregular and inconsistent. I also recorded the S3 heart sound. This sound could be a sign of a systolic heart failure which was likely caused by dilation of the left ventricle.

I have also measured the blood pressure of the patient and he has a low blood pressure. The Electrocardiogram tests have been conducted and lastly a blood test has been conducted to identify the oxygen levels in the blood.

Recommendations

The patient should be tested for other possible conditions like pulmonary embolism, pericardial tamponade, myocarditis, and endocarditis. These are some of the conditions that could lead to heart failure affecting the blood transportation. Upon identifying quick tests should be conducted to determine the real cause of the slowing speed in the blood flow. Once it is identified the patient has carcinogenic shock, the patient should be put under emergency life support and requires to be put under medications. Some of these included inotropic agents to improve his heart functioning, Asprin to reduce blood clotting to improve the patients' blood flow. Lastly, thrombolytics will help to dissolve the blood that had already clotted.

Various pathophysiological conditions could have contributed to the symptoms in patients. Firstly, the increase in the blood sugars could have resulted in the heart complications of the patient. An increase in sugar levels could have led to contraction of blood vessels, and this means the heart has to pump the blood more to ensure every part of the body gets enough supply (Moulaert, van Heugten, Gorgels, Wade & Verbunt, 2017). Moreover, in most cases when the sugars are very high, it is difficult for the heart to cope up with the body's demand for the blood and this leads to heart failure (Ponikowski, 2014). Low blood sugar levels cause acute myocardial infarction which leads to cardiogenic shock.

The patients' lethargic conditions can be attributed to reduced cardiac input which affects the whole body (Ponikowski, 2016). Every tissue and muscles require enough oxygenated blood to carry out respiration which provides them with the energy they need. Some of the cardiac failure complications include reduced cardiac output which affects the ability of the heart to pump blood to the body (Hwang, Melenovsky, & Borlaug, 2014). This alters with the normal functioning of these muscles, and the condition is characterized by a decrease in the normal operation of these organs causing fatigue. The SP02 tests of the patient showed that the patient's body was experiencing an overall low oxygen count (Sidebottom, Jorgenson, Richards, Kirven & Sillah, 2015). Low levels of oxygen can cause cardiogenic shock since the heart also requires oxygenated blood to function normally (Kovacs, Papp & Nagy, 2014). The heart also has muscles that need high energy levels to ensure it pumps the blood efficiently. However, when the oxygen levels are low, it is very likely for the heart to experience heart failure.

The chest pains the patient was experiencing can be attributed to the low oxygen levels (Williams & Thompson, 2014). In this case, the heart muscle was not getting adequate oxygen levels, and as a result, the patient felt these pains in the chest. The pains can also spread to other parts of the body, including the neck, jaws and the back (Williams & Thompson, 2014). These symptoms can be associated with other diseases as well, and that is why patients are advised to seek medical attention early enough. This helps the doctors to identify the exact cause of these symptoms, and it enables them to provide their patients with the necessary care.

Conclusion

Identification of heart diseases is one of the crucial steps when it comes to handling heart diseases conditions. Heart diseases patients should be monitored regularly to ensure the practitioners are aware of the progress of their health. This way it is easy to identify their conditions without experiencing a lot of difficulties. Practitioners should also give their patients immediate medical attention to determine the real cause of their patient's condition. Treatment should then follow upon identifying the real causes of these conditions.

References

Amsterdam, E. A., Wenger, N. K., Brindis, R. G., Casey, D. E., Ganiats, T. G., Holmes, D. R., ... & Levine, G. N. (2014). 2014 AHA/ACC guideline for the management of patients with non-ST-elevation acute coronary syndromes: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Journal of the American College of Cardiology, 64(24), e139-e228. Retrieved from www.onlinejacc.org/content/accj/64/24/2645.full.pdf

Bergum, D., Haugen, B. O., Nordseth, T., Mjolstad, O. C., & Skogvoll, E. (2015). Recognizing the causes of in-hospital cardiogenic shock-A survival benefit. Resuscitation, 97, 91-96. https://doi.org/10.1016/j.resuscitation.2015.09.395

Cowie, M. R., Woehrle, H., Wegscheider, K., Angermann, C., d'Ortho, M. P., Erdmann, E., & Teschler, H. (2015). Adaptive servo-ventilation for central sleep apnea in systolic heart failure. New England Journal of Medicine, 373(12), 1095-1105. Retrieved from https://www.nejm.org/doi/full/10.1056/nejmoa1506459

Hwang, S. J., Melenovsky, V., & Borlaug, B. A. (2014). Implications of coronary artery disease in heart failure with preserved ejection fraction. Journal of the American College of Cardiology, 63(25 Part A), 2817-2827. Retrieved from www.onlinejacc.org/content/accj/63/25_Part_A/2817.full.pdf

Kovacs, A., Papp, Z., & Nagy, L. (2014). Causes and pathophysiology of heart failure with preserved ejection fraction. Heart failure clinics, 10(3), 389-398. DOI: https://doi.org/10.1016/j.hfc.2014.04.002

Moulaert, V. R., van Heugten, C. M., Gorgels, T. P., Wade, D. T., & Verbunt, J. A. (2017). Long-term outcome after survival of a cardiogenic shock: a prospective longitudinal cohort study. Neurorehabilitation and neural repair, 31(6), 530-539. Retrieved from https://journals.sagepub.com/doi/pdf/10.1177/1545968317697032

Ponikowski, P., Anker, S. D., AlHabib, K. F., Cowie, M. R., Force, T. L., Hu, S., ... & Samal, U. C. (2014). Heart failure: preventing disease and death worldwide. ESC Heart Failure, 1(1), 4-25. Retrieved from https://onlinelibrary.wiley.com/doi/pdf/10.1002/ehf2.12005

Ponikowski, P., Voors, A. A., Anker, S. D., Bueno, H., Cleland, J. G., Coats, A. J., ... & Jessup, M. (2016). 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). Developed with the unique contribution of the Heart Failure Association (HFA) of the ESC. European journal of heart failure, 18(8), 891-975. Retrieved from https://academic.oup.com/eurheartj/article/37/27/2129/1748921

Riley, J. P., & Beattie, J. M. (2017). Palliative care in heart failure: facts and numbers. ESC heart failure, 4(2), 81-87. Retrieved from https://onlinelibrary.wiley.com/doi/pdf/10.1002/ehf2.12125

Sidebottom, A. C., Jorgenson, A., Richards, H., Kirven, J., & Sillah, A. (2015). Inpatient palliative care for patients with acute heart failure: outcomes from a randomized trial. Journal of palliative medicine, 18(2), 134-142. Retrieved from https://www.researchgate.net/profile/Arthur_Sillah/publication/269188612_Inpatient_Palliative_Care_for_Patients_with_Acute_Heart_Failure_Outcomes_from_a_Randomized_Trial/links/569954b308ae748dfaff5587/Inpatient-Palliative-Care-for-Patients-with-Acute-Heart-Failure-Outcomes-from-a-Randomized-Trial.pdf

Williams, P. T., & Thompson, P. D. (2014). Increased cardiovascular disease mortality associated with excessive exercise in heart attack survivors. In Mayo Clinic Proceedings (Vol. 89, No. 9, pp. 1187-1194). Elsevier. Retrieved from https://doi.org/10.1016/j.m...