American Board of Surgery Qualifying Exam (ABS QE) Practice Test

In cardiogenic shock, what is the typical state of the cardiac output?

1. Increased

2. Decreased

3. Normal

4. Variable

The correct answer is: Decreased

In cardiogenic shock, the typical state of cardiac output is decreased. This condition arises when the heart is unable to pump sufficient blood to meet the body's needs, often resulting from severe heart problems such as myocardial infarction (heart attack), congestive heart failure, or significant arrhythmias. The reduction in cardiac output leads to inadequate tissue perfusion and oxygen delivery, which is characteristic of cardiogenic shock. Clinically, this can manifest as hypotension, decreased urine output, and altered mental status due to compromised blood flow. Additionally, in cardiogenic shock, the heart's ability to contract is impaired, and the volume of blood being ejected with each heartbeat (stroke volume) is reduced. As a result, therapies often focus on enhancing the contractility of the heart and improving cardiac output to stabilize the patient’s condition. Other potential states of cardiac output like increased or normal do not accurately reflect the physiological changes occurring during cardiogenic shock, where diminished cardiac function is the core issue.