Overview

Cardiogenic shock (CC) is one of the major challenges of current cardiology. Despite the difficulty of establishing a strict and consensual definition, it is accepted that the CC clinically corresponds to persistent hypotension (systolic blood pressure 90 mmHg for at least 30 minutes or need for vasopressor support) associated with signs of visceral hypoperfusion (confusion, mottling, oliguria, hyperlactatemia), and hemodynamic with a lowered heart index ( 1.8 L/min/m2) despite appropriate or high filling pressures. This definition of the European Society of Cardiology (ESC) masks however the great variability of hemodynamic tables grouped under the term of CC and severity levels, also variable.However, it was suggested that the etiology of CC influenced both its hemodynamic profile and therefore its therapeutic management but also its prognosis in the medium and long term.

Eligibility

Inclusion Criteria:

• Patients in Cardiac Shock :
• 90 mmHg hypotension or requiring inotropic or vasopressor support,
• owered cardiac output ( 1.8 L/min/m2) to trans-thoracic cardiac ultrasound with high or normal filling pressures
• peripheral hypoperfusion. patients admitted for acute heart failure (ICA) (Acute pulmonary edema chart or left congestive heart failure without CC sign and with ultrasound FEVG at entry 40%.)

Exclusion Criteria:

• Pregnant or nursing women
• Age 18 years
• Person of full age under guardianship
• Staying in a health or social facility
• Person not covered by a social security scheme
• Person deprived of liberty
• Shocks from other etiologies
• Patient with initial cardiac arrest
• Patient with cardiogenic shock due to right ventricular dysfunction
• Patient with pulmonary embolism
• Patient with tamponade
• Refusal to participate