In terms of hemodynamic changes, which variable is increased in cardiogenic shock?

In cardiogenic shock, the heart's ability to pump blood is severely compromised, leading to inadequate circulation and perfusion of various tissues in the body. One of the hallmarks of this condition is an increase in pulmonary capillary wedge pressure (PCWP). This increase is primarily due to the back pressure created by fluid that accumulates in the pulmonary circulation as a result of left ventricular failure.

When the left ventricle cannot effectively pump blood forward, the pressure within the left atrium and subsequently in the pulmonary veins rises, leading to elevated pressures measured by the wedge catheter. Elevated PCWP indicates increased left atrial pressure, suggesting that the heart is unable to manage the volume being returned to it effectively, culminating in pulmonary congestion and, potentially, pulmonary edema.

The other variables mentioned—cardiac output, right atrial pressure, and systemic vascular resistance—do not reflect the hemodynamic changes seen in cardiogenic shock in the same way. Cardiac output is typically decreased due to impaired myocardial contractility. Right atrial pressure may also rise due to fluid overload or right heart dysfunction but does not experience the same level of significance as PCWP in indicating the severity of pulmonary congestion. Finally, systemic vascular resistance is often increased as a compensatory mechanism