The EM Educator Series: Cardiogenic Shock – Don’t be shock’ed, it’s not sepsis

Author: Alex Koyfman, MD (@EMHighAK) // Reviewed by: Brit Long, MD (@long_brit) and Manpreet Singh, MD (@MprizzleER)

Welcome back to the EM Educator Series. These posts provide brief mini-cases followed by key questions to consider while working. The featured questions provide important learning points for those working with you, as well as vital items to consider in the evaluation and management of the specific condition discussed.

This week has another downloadable PDF document with questions, links and answers you can share with learners as educators in #MedEd. Please message us over Twitter and let us know if you have any feedback on ways to improve this for you. Enjoy!

Case 1:

A 52-year-old male with known heart failure and an ejection fraction of 10% presents with severe shortness of breath and respiratory distress.


Case 2:

A 65-year-old female presents with fatigue, chest pain, and shortness of breath. She is hypotensive and hypoxemia. She has an elevated WBC and lactate, and CXR shows multiple infiltrates. The clinician is treating her for presumed sepsis, but she is worsening with IV fluids.



  • What is a systematic approach to shock?
  • What are the etiologies of cardiogenic shock?
  • What are the ways patients present with cardiogenic shock?
  • What is the utility of labs and imaging?
  • What is the ED-focused management?


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