Table 2

Current clinical and trial definitions of cardiogenic shock

Clinical definitionSHOCK Trial2IABP-SHOCK II1ESC heart failure guidelines6
Cardiac disorder that results in both clinical and biochemical evidence of tissue hypoperfusionClinical criteria:
MI complicated by left ventricular dysfunction
SBP <90 mm Hg for >30 min
or support to maintain SBP >90 mm Hg
and end-organ hypoperfusion (urine output <30 mL/hour or cool extremities)
Haemodynamic criteria:
Cardiac Index <2.2 L/min/m2
and PCWP >15 mm Hg
Clinical criteria:
Acute MI
SBP <90 mm Hg or >30 min
or catecholamines to maintain SBP >90 mm Hg
and clinical pulmonary congestion
and impaired end-organ perfusion (altered mental status, cold/clammy skin and extremities, urine output <30 mL/hour, or lactate >2.0 mmol/L)
Clinical criteria:
SBP <90 mm Hg with adequate volume
and clinical or laboratory signs of hypoperfusion
Clinical hypoperfusion:
Cold extremities, oliguria, mental confusion, dizziness, narrow pulse pressure
Laboratory hypoperfusion:
Metabolic acidosis, elevated serum lactate, elevated serum creatine
  • ESC, European Society of Cardiology; IABP, intra-aortic balloon pump; MI, myocardial infarction; PCWP, pulmonary capillary wedge pressure; SBP, systolic blood pressure; SHOCK, SHould we emergently revascularise Occluded Coronaries for cardiogenic shocK.