What laboratory tests are indicated for diagnosing cardiogenic shock?

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Last updated: February 16, 2025View editorial policy

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From the Guidelines

Laboratory Tests for Diagnosing Cardiogenic Shock

In patients suspected of cardiogenic shock, laboratory evaluation should include complete blood count, basic metabolic panel, liver function tests, troponin levels, and lactate levels to assess for tissue hypoperfusion 1.

  • Additionally, arterial blood gas analysis and coagulation studies, including prothrombin time and partial thromboplastin time, should be obtained to guide management 1.
  • Serial electrocardiograms and cardiac biomarkers, such as creatine kinase-MB, should also be monitored to assess for myocardial injury 1.
  • These tests are crucial for diagnosing cardiogenic shock, guiding management, and assessing the patient's response to treatment.
  • The use of B-type natriuretic peptide (BNP) or NT-pro-BNP may also be considered to supplement the assessment of global risk in patients with suspected cardiogenic shock 1.
  • It is essential to note that the diagnosis of cardiogenic shock is primarily clinical, and laboratory tests should be used to support the diagnosis and guide management, rather than relying solely on laboratory results 1.

From the Research

Laboratory Tests for Diagnosing Cardiogenic Shock

The following laboratory tests are indicated for diagnosing cardiogenic shock:

  • Electrocardiogram 2
  • Chest radiograph 2
  • Laboratory studies, including:
    • Troponin 3
    • CKMB 3
    • Lactate 3
    • Liver function tests, such as alanine aminotransferase (ALT) 4
    • Alkaline phosphatase 4
    • Gamma-glutamyl transferase 4
    • Total bilirubin 4
  • Bedside echocardiogram 2
  • Coronary angiography, particularly when acute myocardial ischemia is suspected 5
  • Invasive hemodynamic assessment to clarify whether temporary mechanical circulatory support is necessary 5

Rationale for Laboratory Tests

These laboratory tests are used to evaluate the possible etiology of cardiogenic shock, its systemic repercussions, and comorbidities 3. They help assess organ dysfunction and appropriate risk stratification, which are central for the optimal management of patients with cardiogenic shock 4. The results of these tests can guide treatment decisions, such as the need for temporary mechanical circulatory support or coronary angiography 5.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Cardiogenic Shock.

Cardiology clinics, 2018

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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