Your patient has a decreased cardiac output and poor myocardial contractility. This will likely lead to ___________.

• A. Hypovolemic shock
• B. Cardiogenic shock
• C. Neurogenic shock
• D. Septic shock

Answer: (D)

Impaired pumping of the heart causes a drop in cardiac output, which is the defining feature of cardiogenic shock. When the myocardium is weak or injured, its ability to eject blood is reduced, so less oxygenated blood reaches the tissues despite normal or even increased circulating volume. The body may try to compensate with tachycardia and vasoconstriction, but perfusion remains inadequate, leading to signs of poor tissue perfusion and potential pulmonary congestion from backward pressure. This differs from septic shock, where the main issue is widespread vasodilation and capillary leak rather than primary pump failure; neurogenic shock involves loss of sympathetic tone with vasodilation, and hypovolemic shock centers on insufficient blood volume. Therefore, decreased cardiac output and poor myocardial contractility point to cardiogenic shock.