Question

What is the cause of cardiogenic (myocardial) shock other than acute myocardial infarction?

• A. Acute mitral regurgitation
• B. Ventricular septal rupture
• C. Isolated right ventricular shock
• D. All of the above

Hint:

Mechanical complications and right-heart failure all cause pump shock, not just MI.

Answer 1

The Correct Option is D

Step 1: Cardiogenic shock is a state of inadequate tissue perfusion caused by failure of the heart as a pump. Acute MI with left ventricular dysfunction is the single most common cause, but it is far from the only one.
Step 2: Mechanical and non-ischaemic causes also produce cardiogenic shock. Acute mitral regurgitation (for example from papillary muscle rupture) causes sudden volume overload of the left atrium and a fall in forward output.
Step 3: Ventricular septal rupture creates an acute left-to-right shunt, reducing effective systemic stroke volume and precipitating shock.
Step 4: Isolated right ventricular failure (for example massive pulmonary embolism or RV infarction) reduces left-sided filling and output, again causing cardiogenic shock.
Step 5: Because acute mitral regurgitation, ventricular septal rupture and isolated right ventricular shock are all recognised causes, the correct response is \(\textbf{all of the above}\). Choosing any single option alone would be incomplete.