• rapid pulse
• pulse may be weak (thready)
• rapid breathing
• anxiety, nervousness
• skin may feel cool to touch
• weakness, lethargy, fatigue
• decreased mental status
  • loss of alertness
  • loss of ability to concentrate
• restlessness, agitation, confusion
• coma
• skin color pale or mottled
• profuse sweating, moist skin
• decreased urine output (or none)
• poor capillary refill

An examination will reveal low blood pressure (less than 90 systolic), and the blood pressure may drop more than 10 points when the patient stands up after lying down (orthostatic hypotension). The pulse may be weak or absent.

To diagnose cardiogenic shock, a catheter (tube) may be placed in the pulmonary artery. Measurements often indicate that blood is backing up into the lungs and that the heart has poor pumping function.

Tests used in patients with cardiogenic shock include:

• electrocardiogram
• coronary angiography
• echocardiogram
• nuclear scans

Other tests may be recommended to determine the cause of the heart's failure to function properly.

Laboratory tests include:

• CBC
• type and cross-match blood for possible transfusion
• arterial blood gas
• blood chemistry (chem-7, chem-20, electrolytes, cardiac enzymes)