I wasn’t sure whether it’s better to combine all the cardiac conditions into one massive article or discuss them separately, so for the sake of brevity we’ll do them one at a time.

Note: For charts showing the full calendar year, 2022 is only through October 26 and may be missing a few October deaths that weren’t submitted and/or processed at the time I acquired the data from Vermont.

Cardiogenic Shock

One of the clearest anomalies in the Vermont death certificates is cardiogenic shock.

What is cardiogenic shock?

According to the NIH, “Cardiogenic shock, also known as cardiac shock, happens when your heart cannot pump enough blood and oxygen to the brain and other vital organs.”

In other words, the heart is too damaged to pump enough blood around to the entire body to keep critical organs alive.

Cardiogenic Shock Data

Here are a series of charts that present a fairly comprehensive picture of deaths involving cardiogenic shock (from hereon C-Shock):

Chart #1: Total number of deaths involving cardiogenic shock, full calendar year:

Chart #2: Line graph showing cumulative total of deaths involving cardiogenic shock in half-month intervals

Chart #3: Breakdown of C-Shock deaths into Cause A / Cause B/C/D/Other

Chart #4: Average age of C-Shock deaths by year

Chart #5: % of C-Shock deaths by gender

Chart #6: Breakdown of C-Shock deaths by age cohort

Chart #7: Breakdown of C-Shock deaths by place of death and gender

Analysis

Something happened in 2021 that caused cardiogenic shocks to start soaring. This much is undeniable. The question is WHY.

Are the excess cardiogenic shock deaths of 2021 a clinical or administrative phenomenon?

The first thing we must determine is what the increase in cardiogenic shock deaths represents – does it reflect a change in the clinical causes of death, or is it an artifact of a shift in how ME’s/attending physicians assigned a CoD (what I am referring to as an “administrative phenomenon”)? This is not merely an abstract hypothetical question – death certificates are notoriously inaccurate and subject to widely varying conventions and degrees of competence by those who fill them out. We can attempt to adjudicate this by looking at the characteristics of C-Shock deaths, to see if they are inconsistent with this trend being a clinical or administrative phenomenon.

Exhibit A: Cardiogenic shock is a CoD that is exclusive to hospital deaths:

This is way too lopsided to be random.

Why would a fairly general CoD – one that would seem to be applicable to deaths outside a hospital as much as inside a hospital – only be diagnosed and/or documented in a hospital? Cardiac arrests – a very similar if not identical pathology from an ‘administrative’ perspective (and one that often is the result of cardiogenic shock) – are frequently documented on death certificates outside of hospitals:

(There is a clear signal of excess mortality in cardiac arrests, which will be the subject of an upcoming post.)

It is highly dubious that ME’s discriminates against non-hospital deaths exclusively when it comes to cardiogenic shock.

This implies that cardiogenic shock is not a diagnosis of conjecture – something that an ME would put on a death certificate as an ‘educated guess’ – but rather is a diagnosis confirmed by a clinical test or examination.

Indeed, if we look at the NIH page cited above, we find the following:

To diagnose cardiogenic shock, a catheter (tube) may be placed in the lung artery (right heart catheterization). Tests may show that blood is backing up into the lungs and the heart is not pumping well.

Tests include:

• Cardiac catheterization
• Chest x-ray
• Coronary angiography
• Echocardiogram
• Electrocardiogram
• Nuclear scan of the heart

For the record, I asked a number of healthcare providers of various credentials about diagnosing cardiogenic shock, and there was a general consensus that it is something that is easily, accurately, and reliably diagnosed (at least in a hospital setting).

At any rate, since hospitals are uniquely disposed to testing for and confirming a diagnosis of cardiogenic shock (they interdict patients while they are still alive – however fleeting that may last – plus they have all the patients hooked up to vital sign monitors and healthcare personnel check in on patients more frequently than they do in nursing homes, hospices, and at the decedent’s house), it is plausible that cardiogenic shock would only be diagnosed in a hospital setting.

This suggests that the spike in cardiogenic shock deaths in 2021 is a clinical phenomenon reflecting a spike in a specific pathology that was killing people.

Exhibit B: The inversion of the gender breakdown

In the 5 years before the pandemic, cardiogenic shock was dominated by women (black lines); whereas in all three pandemic years, men have the advantage:

The one pre-pandemic year where the men have more cardiogenic shocks than the women is 2017, which saw excess cardiogenic shocks solely in men – as you can see in the below chart, while women are essentially flat, men in 2017 have almost 100% excess C-Shock excess deaths – double the expected C-Shock mortality – and explode in 2021:

Is it plausible that this gender-specific trend could be the product of subjective standards or decisions by MEs or bureaucratic diktat? I doubt it. If there were a shift in how CoDs were being assigned or diagnosed, it should show up in both genders, especially for a CoD that is distributed pretty evenly overall between both genders.

It is far more plausible that the excess C-Shock deaths in men reflect the increase in a pathology/s that caused a genuine excess of cardiogenic shocks.

Ergo, it is reasonable to presume that the excess cardiogenic shock deaths are capturing a real clinical phenomenon of unexpected excess deaths caused by a pathology/s that results in cardiogenic shock.

What is causing the increase in deaths caused by or involving cardiogenic shock?

Since we can reasonably assume that there is indeed a genuine increase in fatal cardiogenic shocks, we can now try and see if we can figure out what is causing this increase, or at least rule out potential hypotheses.

Exhibit A: Timing

The most salient characteristic relevant to figuring out what can or cannot be responsible for this trend is when did it occur. Obviously, if ‘A’ caused ‘B’, it has to fit chronologically. If there is little relationship between the occurrence of ‘A’ and ‘B’, it is unlikely if not impossible that ‘A’ is causing ‘B’.

Here is the trendline of cumulative cardiogenic shock deaths (the black line is where the trend starts to deviate from the pre-pandemic average; the purple line is where it starts to explode):

Can this be explained by covid?

I think we can safely rule out covid from contention here:

• Covid was around in 2020, including a significant winter 2020/21 wave, yet there was no surge in cardiogenic shocks.
• There was only ONE death that listed both covid *and* cardiogenic shock in 2020, and only TWO such deaths in 2021.
• The surge does not coincide with any covid wave – it falls smack in the middle of the lull between the 2020 winter wave and the 2021 fall apocalypse:

This cannot plausibly be chalked up to long covid either – long covid would not cause a sudden, massive surge first starting a full 15-18 months after covid began spreading around the US. Furthermore, the C-Shock curve does not match any covid curve in Vermont, even one offset by 15 months.

Can this be explained by the covid vaccines?

If you look at where this trend begins, it mirrors vaccine uptake offset by about 5 months – a slow start for a few weeks as vaccines were in very short supply but picking up afterward as vaccines became more readily available and deployed:

Cardiogenic shock is almost exclusively in the senior population – who were overwhelmingly the recipients of the vaccines at the start of the vaccine rollouts – with only *ONE* death under the age of 40:

There is a hypothesis that a subset of vaccine deaths take approximately 5 months to begin to manifest (

and

are notable proponents of this theory), which lines up perfectly with Vermont’s trend of cardiogenic shock excess deaths that kicks off almost to a ‘T’ 5 months after the vaccines were first introduced.

Pathology of the excess cardiogenic shocks

We can drill down a little and discern somewhat the nature of the basic pathology that is afflicting people that is leading to excess death from cardiogenic shock. Specifically, is the heart damage secondary to something else, or is it the primary catalyst that led to the death of the patient?

Cause A vs Secondary Causes

The breakdown of C-Shock deaths listed as the direct/primary cause – Cause A – vs a secondary or underlying cause shows that the *EXCESS* C-Shock deaths are almost entirely found in Cause A deaths (black circled are pretty even, the green circled are clear excess):

Here is the same data combined onto one chart – Cause A (purple bars) is where the excess is at, while other causes (green bars) are pretty flat across all years including the pandemic):

The locus of excess deaths almost entirely in Cause A deaths suggests that the heart damage captured as cardiogenic shock is the primary catalyst or culprit behind these deaths. In other words, there is a novel ‘something’ in 2021 that causes heart damage which in turn leads to the heart being unable to pump enough blood to critical organs (including the heart itself), which eventually kills the patient.

We know that the covid vaccines can result in cardiogenic shock – especially considering that cardiogenic shock itself can be precipitated by [mild, safe and effective] myocarditis among other things:

Personally, I suspect that this excess cardiogenic shock is hiding vaccine-associated myo/pericarditis in seniors. Yes, vaccine myocarditis strikes even lovely octogenarian ladies:

**Note the diagnosis of cardiogenic shock here**

Unlike younger people, seniors are far less likely to be able to withstand even ‘mild’ (ie a small amount of) heart inflammation. If you’re young, then losing a bit of cardiac output or function in itself isn’t going to kill you in the short or mid term (although a sudden arrhythmia from the disruption of electrical signaling impeded by scar tissue might). On the other hand, a 77 yo man with five conditions does not have ‘spare’ cardiac function that he can lose and still survive, so a bit of ‘mild’ myocarditis (and for sure a nice, big splotch of myocardial or pericardial inflammation) can eventually reduce cardiac function below the minimum necessary to survive.

It certainly seems plausible to me that hospitals would rather not figure out the underlying cause of heart damage these days, and are therefore incentivized to leave diagnosed heart damage as simply that – something that could easily be diagnostically captured as [just an unfortunate] cardiogenic shock. “Myocarditis only affects young males” has been their go-to talking point to discount and disrepute the data showing widespread cardiovascular carnage from the vaccines to all age groups, one that they can ill afford to lose – you won’t find what you don’t look for.

The totality of cardiac-related deaths

I have noticed that there seems to be some degree of interchangeability between the various conditions of some organ systems or diseases. For instance, there seems to be some amount of balancing out between embolism and thrombosis – they fluctuate somewhat from year to year but combined they even out.

If there is a decrease in other types of cardiac deaths corresponding to the increase in cardiogenic shock deaths, then the most likely interpretation is that cardiac deaths that would usually be documented as a cardiac arrest for instance are instead for whatever reason being documented as cardiogenic shock.

The short answer here is that other cardiac conditions do not decrease while the cardiogenic shock deaths increase (for instance see the chart of cardiac arrest deaths earlier), so the cardiogenic shock excess cannot be attributed to simply labeling other cardiac-related deaths as cardiogenic shock.

I hope to write a dedicated post on this specifically at some point.

‘Seeing through’ a pull-forward effect

There is a further point in this vein that is worth fleshing out a little.

One of the biggest confounders in discerning excess mortality in 2021 and 2022 is the “pull-forward” effect.2

A substantial increase in a defined clinical condition or pathology however can rise above this to some extent, because we are able to identify a definite excess in the excess deaths from this specific condition, regardless of the total nominal number of deaths. Obviously, this is not by itself conclusive proof of anything, but as part of a broader mosaic of evidence and data, it is helpful to better pinpointing or clarify what and where the excesses we are seeing in various data are.

Caveats

There are several important caveats to this analysis that must be stipulated.

Small sample size

Although the signal is large enough that it cannot be written off to random chance, it is way too small to definitively prove anything specific. That notwithstanding, it jives well with a lot of other evidence and observations about the devastation wrought by the covid vaccines.

Subjective and/or arbitrary nature of death certificates

Death certificates are notoriously fickle, error-prone, and rife with inaccuracies. It is possible that there are ‘administrative’ variables in play here affecting how CoD’s are being designated.

In a nutshell, there is a clear and undeniable massive spike in deaths involving cardiogenic shock in 2021.

The fact that every single death but one occurred in a hospital, and that the excess occurred almost exclusively in men, suggests that this trend is not the product of human decisions or arbitrary changes in CoD conventions; but rather reflects a genuine clinical phenomenon of unanticipated excess mortality caused by heart damage captured with a diagnosis of cardiogenic shock.

This is buttressed by the lopsided distribution of the excess to Cause A CoD, which implies firstly that this trend is not random; and secondly, that the heart damage was a, if not the, primary CoD in these excess cardiogenic shock deaths.

Moreover, while the timing of the excess cardiogenic deaths suggests that it is implausible to attribute them to covid, long covid, or the consequence of some other pandemic policy, it is consistent with the vaccine rollouts.

Finally, there is ample mechanistic basis to support the hypothesis that these excess deaths were ultimately caused by a pathology initiated by a covid vaccine.