Shock is a specific clinical manifestation caused by a disease. It is mainly caused by circulatory dysfunction, which leads to insufficient tissue blood perfusion, leading to abnormal function of various organs. There are different causes due to different mechanisms of shock; among them, psychogenic factors Sexual shock may be caused by severe myocardial infarction and arrhythmia, which may lead to sudden death. What exactly is psychogenic shock? What are the causes of psychogenic shock? How to treat and prevent it?

What is psychogenic shock?

The heart is like a pump, responsible for transporting blood rich in nutrients and oxygen to all parts of the body. Psychogenic shock means that the heart fails and cannot continue to pump blood, causing the following problems:

1. Impaired myocardial contractile function
   
2. Decreased cardiac output
   
3. Peripheral vasoconstriction and insufficient tissue blood perfusion
   
4. Organ ischemia, hypoxia

Causes of psychogenic shock

Myocardial infarction, also known as heart attack, is one of the most common causes of psychogenic shock in adults; according to statistics, about 5 to 10% of patients with acute myocardial infarction will develop psychogenic shock, and psychogenic shock is also Acute myocardial infarction is the main cause of death, with a mortality rate of 25 to 50%.

The difference between myocardial infarction and cardiogenic shock is that the former refers to the blockage of the coronary arteries of the heart, causing the supply of blood and oxygen to the heart muscles to be blocked, but at this time the heart function can still be barely maintained; the latter refers to the heart losing its pump function. , unable to transport blood to various organs in the body. Myocardial infarction may not cause psychogenic shock. Patients may only have angina or chest pain, but without emergency treatment, it may evolve into psychogenic shock. On the contrary, in addition to myocardial infarction, the following reasons can also cause psychogenic shock:

1. Myocarditis
   
2. Severe arrhythmia
   
3. Pericardial tamponade
   
4. Endocarditis
   
5. Pulmonary embolism
   
6. Acute valvular heart disease

Signs and symptoms of psychogenic shock

Common symptoms of myocardial infarction or other heart diseases are possible precursors of cardiogenic shock and require early medical treatment:

1. Chest pain, chest tightness
   
2. Angina pectoris
   
3. Arrhythmia
   
4. Unsmooth breathing, difficulty breathing
   
5. Abdominal pain
   
6. Breaking into a cold sweat
   
7. Dizziness, nausea and vomiting
   
8. Easily tired, weak and generally weak
   
9. Cough, coughing up blood

Clinically, patients will experience severe hypotension, shortness of breath, edema and coldness of limbs, and cyanosis (limbs turn purple, face turns dark blue) after shock. This is not the loss of consciousness or lack of breathing that ordinary people think. Therefore, if related symptoms occur, Please seek medical attention immediately to avoid worsening and sudden death.

How is shock diagnosed?

Symptoms of shock include:

1. Hypotension: blood pressure less than 90mmHg or need to use vasopressors to maintain blood pressure
   
2. Insufficient perfusion of peripheral organs: urine output is less than 30 ml per hour, consciousness changes, the skin of the limbs is clammy or the blood lactate value is greater than 2.0mmol/L, etc.
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However, in order to distinguish whether the cause of shock is psychogenic, allergic or other factors, the doctor may arrange the following examinations to prescribe appropriate treatment:

1. Blood test
   
2. Chest X-ray
   
3. Electrocardiogram
   
4. Cardiac ultrasound
   
5. Chest computed tomography

How is psychogenic shock treated?

Once cardiogenic shock is diagnosed, the patient needs to stabilize blood pressure and oxygenation status as soon as possible to improve tissue perfusion and increase oxygen output. Treatment methods include:

1. Cardiotonics
   
2. Vasoconstrictor drugs
   
3. Infusion therapy: It needs to be monitored with hemodynamic instruments to avoid edema caused by excessive infusion.
   
4. Extra-corporeal membrane oxygenation: If the drug is not effective, an extracorporeal circulation life support system needs to be used to stabilize blood pressure.

f the patient develops respiratory failure due to pulmonary edema or pulmonary embolism due to heart failure, he or she will need to be intubated to maintain oxygenation of the gas in the lungs.

After the patient’s condition stabilizes, the doctor will treat the cause of the disease. For example, myocardial infarction requires solving the blocked coronary artery, heart failure may require the use of a ventricular assist device, etc.