Houston SHOCK: A Practical Scoring System Incorporating Cardiogenic Shock Dynamic Changes

Cardiogenic shock has an unacceptably high mortality rate and additional tools are needed to improve outcomes. The Society of Cardiovascular Angiography and Interventions (SCAI) shock severity classification has provided a unified definition of shock severity that has proven to be reproducible and predictive of survival. However, cardiogenic shock assessment goes beyond standardizing its severity, and a uniform and practical approach to comprehensive assessment that may guide therapy in a dynamic state is currently lacking. Since cardiogenic shock is a rapidly evolving pathophysiological catastrophe, we propose a new assessment tool – the Houston SHOCK Score – which incorporates dynamic changes. The acronym SHOCK can be used to emphasize five key aspects of patients in cardiogenic shock: Severity, Hemodynamics, Onset, Causes, and Kinetics. We believe this tool provides physicians with vital information that will facilitate appropriate care by incorporating dynamic changes in the patient’s profile.