A large new study has revealed that even in the early stages of cardiogenic shock (CS)—a serious heart condition where blood flow is still reaching major organs—more than one in four patients experience serious complications or death. These findings were shared as part of the Society for Cardiovascular Angiography & Interventions (SCAI) 2025 Scientific Sessions.
Cardiogenic shock happens when the heart suddenly can’t pump enough blood to meet the body’s needs. This leads to a drop in blood pressure and low oxygen supply to organs. It’s a life-threatening emergency. Around half of all people diagnosed with CS die before they leave the hospital.
While doctors are well aware of how dangerous advanced stages of CS are, very little has been studied about the outcomes of people who are in the earlier stages—when blood flow still appears to be somewhat stable.
This new study is one of the largest of its kind. Researchers looked at the medical records of 500 patients with early-stage CS (known as Stage B in the SCAI shock classification) across six hospitals within the Brown University Health system. Stage B is considered the beginning phase of shock, when the heart’s function is starting to decline but full shock hasn’t yet set in.
Patients were included in the study if they had low blood pressure or signs of poor blood flow (like increased blood lactate levels), but did not have other problems such as cardiac arrest, infections, or low blood volume from other causes.
The goal of the study was to find out how many patients with early CS either got worse, needed to be transferred to a more intensive level of care, or died in the hospital.
The researchers found that 132 out of the 500 patients—about 26%—met at least one of these serious outcomes. Most of these events happened quickly, with the median time to worsening condition being just 16 hours after admission.
What made some patients more likely to have a bad outcome? The study found that these patients usually came in with lower blood pressure, weaker heart function (as shown by lower ejection fraction), and less urine output in the first 24 hours—indicating early signs of kidney trouble.
They were also more likely to show signs of kidney and liver damage, or bloodstream infections.
The most common causes of early CS in this study were heart failure (42%), irregular heartbeats (25%), heart attacks (13%), and structural heart problems (3%), with the rest involving a mix of these issues.
Dr. Saraschandra Vallabhajosyula, senior author of the study and a critical care cardiologist at Brown University, emphasized the importance of recognizing the seriousness of early CS. “These patients are often not seen as severely ill, but this study shows that over 25% of them do very poorly,” he said. “This highlights the need for early recognition and action.”
In conclusion, this research sends a clear message: early cardiogenic shock is not as harmless as it may look. Doctors and hospital teams need to watch these patients closely and act quickly to prevent further complications.
It also underlines the importance of teamwork across different specialties—cardiology, critical care, emergency medicine—to spot early warning signs and intervene before the condition worsens. By improving how quickly and accurately early CS is diagnosed, the hope is that more lives can be saved in the critical first hours after hospital admission.
If you care about heart health, please read studies that vitamin K helps cut heart disease risk by a third, and a year of exercise reversed worrisome heart failure.
For more health information, please see recent studies about supplements that could help prevent heart disease, stroke, and results showing this food ingredient may strongly increase heart disease death risk.
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