What is the most common cause of cardiogenic shock?

Myocardial infarction (MI) is recognized as the most common cause of cardiogenic shock due to its direct impact on the heart’s ability to pump effectively. During an MI, the blood supply to a part of the heart muscle is obstructed, leading to ischemia and subsequent necrosis of cardiac tissue. This impairment in myocardial contractility results in reduced cardiac output, often requiring compensatory mechanisms that can fail, culminating in cardiogenic shock.

In addition, cardiogenic shock can arise when a significant portion of the heart muscle is damaged, such as with extensive anterior MIs, further weakening the heart's pumping ability. This condition leads to systemic hypoperfusion, organ dysfunction, and the clinical signs associated with shock. While other conditions may contribute to or precipitate shock, myocardial infarction stands out as the primary cause in acute settings, particularly in populations at risk for coronary artery disease. Understanding the underlying pathophysiology of MI helps inform both management strategies and the urgency of intervention in these patients.