Hemodynamic changes and clinical implications in cardiogenic shock

Among cardiovascular emergencies, cardiogenic shock stands out for its severity and difficulty in management. Its genesis lies in the heart's inability to sustain effective blood flow, leading to widespread hypoperfusion and rapid organ deterioration. More than a purely cardiac phenomenon, this condition expresses hemodynamic collapse that impacts multiple systems, increasing the risk of death. To understand the central aspects of this syndrome, a narrative review was conducted covering publications available in PubMed, SciELO, and BVS, from 2015 to 2025. The literature analysis revealed that the main markers of the condition include low cardiac output, elevated filling pressures, and a compensatory increase in systemic vascular resistance, resulting in pulmonary edema, oliguria, neurological changes, and severe metabolic disorders. Such changes make early intervention essential, which involves not only pharmacological and ventilatory support, but also invasive therapies such as coronary revascularization and circulatory assist devices. It is concluded that cardiogenic shock should be interpreted as a systemic syndrome, in which the rapid identification of hemodynamic changes and the implementation of immediate interventions are crucial to reduce its high mortality and offer better therapeutic prospects.