NREMT Emergency Medical Technician (EMT) Cognitive ExamCardiology & ResuscitationMedium
An EMT is assessing a 60-year-old male complaining of suddenly feeling unwell. He is cool, pale, diaphoretic, and reports crushing substernal chest pain radiating to his left arm. His blood pressure is 88/50 mmHg, pulse is 110 bpm and thready, and respirations are 22 bpm. Lung sounds are clear. What type of shock is this patient most likely experiencing?
- ACardiogenic shock
- BAnaphylactic shock
- CNeurogenic shock
- DHypovolemic shock
Show answer & explanationAnswer & explanation
Correct answer: A. Cardiogenic shock
The patient's presentation of crushing chest pain, hypotension (88/50 mmHg), tachycardia (110 bpm), and signs of poor perfusion (cool, pale, diaphoretic) with clear lung sounds is highly indicative of cardiogenic shock. This occurs when the heart cannot pump enough blood to meet the body's needs, often due to a myocardial infarction.
Why the other options are wrong
- B. Anaphylactic shock involves a severe allergic reaction, often with hives, angioedema, and bronchospasm, which are not present.
- C. Neurogenic shock is caused by spinal cord injury, leading to vasodilation, often with bradycardia and warm, dry skin, which contradicts this patient's presentation.
- D. Hypovolemic shock would typically present with signs of fluid loss, not primary chest pain and clear lungs.
Cardiogenic Shock
Cardiogenic shock is a state in which the heart has been damaged to the point where it is unable to supply enough blood to the body's organs. It typically follows a severe myocardial infarction.
- Caused by severe pump failure of the heart.
- Often associated with acute myocardial infarction.
- Presents with hypotension, tachycardia, signs of hypoperfusion, and sometimes pulmonary edema (though not in this case).
Memory trick: Heart's a mess, pressure's low, perfusion's slow.