The clinical definition of cardiogenic shock is decreased cardiac output and evidence of tissue hypoxia in the presence of adequate intravascular volume. Hemodynamic criteria are sustained hypotension (systolic blood pressure , 90 mm Hg for at least 30 minutes) and a reduced cardiac index 2.2 L/min per m2 in the presence of elevated pulmonary capillary occlusion pressure (15 mm Hg).