CardiologyAnaesthesia & ICU
Cardiogenic Shock
ESC 2023 — SCAI staging, identification of cause (ACS most common), inotropes/vasopressors, mechanical circulatory support, urgent revascularisation.
Source: ESC 2023 ACS; SCAI 2019
Used in: Acute Coronary Syndrome & Chest Pain
Step 1 of ~8
info
Recognise & Stage (SCAI A–E)
Definition: SBP <90 + ≥1 sign of end-organ hypoperfusion (lactate >2, oliguria, ALOC, cool peripheries) attributable to cardiac dysfunction. SCAI stages: A (at-risk) → B (beginning) → C (classic, requires inotrope/vasopressor) → D (deteriorating, multiple drugs/MCS) → E (extremis, refractory). Most commonly ACS — also myocarditis, valvular catastrophe, post-cardiotomy, tamponade, PE, arrhythmia.
Related
Curated clinical cross-links plus same-class fallbacks.
Drugs
- Noradrenaline (Cardiogenic Shock / Vasopressor) · Vasopressor / Cardiogenic Shock
- Hydrocortisone (ICU — Stress Dosing) · Corticosteroid (ICU/Septic Shock)
- Folinic Acid (Calcium Folinate / Leucovorin) · Antidote / Chemotherapy Support
- Vasopressin / Terlipressin · Vasopressin Analogue — Vasodilatory Shock / Variceal Bleeding
- Bendroflumethiazide · Thiazide Diuretic
- Enteral feeds · Nutritional support
Pathways
- Acute Heart Failure · ESC 2021 Heart Failure Guidelines; NICE NG106
- NSTEMI / Unstable Angina · ESC 2020 NSTEMI Guidelines; NICE NG185
- New-Onset Atrial Fibrillation · ESC 2020 AF Guidelines; NICE NG196
- Hypertensive Emergency · ESC/ESH 2018 Hypertension Guidelines; NICE NG136
- Bradycardia Management · Resuscitation Council UK ABCDE; ESC 2021 Pacing Guidelines
- Ventricular Tachycardia / Fibrillation · Resuscitation Council UK ACLS; ESC 2022 Ventricular Arrhythmia Guidelines
Featured in these MRCEM clinical pathways
A deeper exam-focused version of this pathway is available on our sister siteReviseMRCEM.
MRCEM Primary / Intermediate / OSCE candidates: each pathway includes exam-style questions, RCEM/NICE citations, and FAQ summaries.
Decision support only. Always apply local guidelines and clinical judgement.