Cardiogenic Shock

Clinical Case:

A 30-year-old female presented to the ER with:

• Fever with chills: 2 days
• Chest pain: 1 day
• Breathlessness: 1 day
  There was no history of cough, hemoptysis, or other localizing signs.

Vitals at Presentation:

• Heart Rate: 130/min
• Blood Pressure: 90/70 mmHg
• Respiratory Rate: 30/min
• SpO₂: 80% on room air

Physical Examination:

• Cold peripheries
• Prolonged capillary refill time

Echocardiography:

• Ejection Fraction (EF): 25%
• Velocity Time Integral (VTI): 14 cm

Laboratory:

• Lactate: 4.5 mmol/L