What is an initial management step listed for hypotension in suspected cardiogenic shock?

• A. Fluid resuscitation
• B. Antibiotics
• C. Anticoagulation
• D. Dialysis

Answer: (A)

In this scenario, the first priority is to assess and support perfusion while evaluating volume status. A cautious fluid bolus is often given to see if increasing preload improves blood pressure and organ perfusion, especially when there may be a component of underfilling or mixed shock. This helps determine whether the heart can respond to more preload or if the problem lies primarily in pump failure. The goal is to stabilize circulation while planning definitive therapy for cardiogenic shock, such as vasopressors or inotropes and addressing the underlying cause (like revascularization if an acute MI).

Antibiotics aren’t the immediate step unless sepsis is suspected or there’s an alternative infectious source. Anticoagulation is not routinely started in cardiogenic shock unless a thrombotic process is suspected or confirmed. Dialysis isn’t a first-line intervention for hypotension due to cardiogenic shock and would be considered later if renal dysfunction or fluid overload necessitates it.