If hypotension is due to cardiogenic shock, which hemodynamic pattern would you expect?

If hypotension is due to cardiogenic shock, which hemodynamic pattern would you expect?

• A. CO ↑, CI ↑, CVP ↓, PAP ↓, PAOP ↓, SVR ↓
• B. CO ↓, CI ↓, CVP ↑, PAP ↑, PAOP ↑, SVR ↑
• C. CO ↑, CI ↓, CVP ↓, PAP ↓, PAOP ↓, SVR ↑
• D. CO ↓, CI ↓, CVP ↓, PAP ↑, PAOP ↑, SVR ↑

Answer: (B)

In cardiogenic shock the heart’s pumping is severely impaired, so forward flow drops while pressures build up behind the failing ventricle. The typical picture is a low cardiac output that, when indexed to body size, is also low, with elevated filling pressures from venous and pulmonary congestion. So you’d expect decreased CO and CI, with increased CVP, PAP, and PAOP due to backup into the venous system and lungs. The body also constricts vessels to maintain pressure, raising systemic vascular resistance. That combination—CO and CI down, CVP up, PAP up, PAOP up, SVR up—matches the cardiogenic shock pattern. Other patterns would show low filling pressures (as in hypovolemia) or high output with low SVR (as in distributive/early sepsis), which aren’t present here.

In cardiogenic shock the heart’s pumping is severely impaired, so forward flow drops while pressures build up behind the failing ventricle. The typical picture is a low cardiac output that, when indexed to body size, is also low, with elevated filling pressures from venous and pulmonary congestion. So you’d expect decreased CO and CI, with increased CVP, PAP, and PAOP due to backup into the venous system and lungs. The body also constricts vessels to maintain pressure, raising systemic vascular resistance. That combination—CO and CI down, CVP up, PAP up, PAOP up, SVR up—matches the cardiogenic shock pattern. Other patterns would show low filling pressures (as in hypovolemia) or high output with low SVR (as in distributive/early sepsis), which aren’t present here.