NREMT Emergency Medical Technician (EMT) Cognitive ExamCardiology & ResuscitationMedium
A 65-year-old female is experiencing altered mental status, cool and clammy skin, and a rapid, weak pulse of 120 bpm. Her blood pressure is 80/50 mmHg. She has a history of a recent large myocardial infarction. What type of shock is she MOST likely experiencing?
- ADistributive shock.
- BObstructive shock.
- CCardiogenic shock.
- DHypovolemic shock.
Show answer & explanationAnswer & explanation
Correct answer: C. Cardiogenic shock.
The patient's history of a recent large myocardial infarction, coupled with signs of hypoperfusion (altered mental status, cool/clammy skin, rapid/weak pulse, hypotension), strongly suggests cardiogenic shock. This occurs when the heart's pumping ability is severely impaired, often after a large heart attack.
Why the other options are wrong
- A. Distributive shock (e.g., septic, anaphylactic, neurogenic) involves widespread vasodilation; while it causes hypotension, the MI history is a strong indicator for cardiogenic.
- B. Obstructive shock involves a physical obstruction to blood flow (e.g., tension pneumothorax, pulmonary embolism), which is not directly indicated by her history of MI as the primary cause of shock.
- D. Hypovolemic shock is due to fluid loss; while she has hypoperfusion, the MI history points elsewhere.
Cardiogenic Shock
A state of inadequate tissue perfusion due to severe cardiac pump failure, often caused by a large myocardial infarction.
- Caused by heart's inability to pump enough blood.
- Commonly follows a large heart attack.
- Signs: hypotension, tachycardia, altered mental status, cool/clammy skin, pulmonary edema.
- Treatment focuses on improving cardiac output and maintaining perfusion.
Memory trick: H-C-O-D, the types of shock you see!