Aim for MAP >65
Consider etiologies (see above) and treat specific one, if present
Consider small fluid challenge (250-500cc normal saline IV) or fluid removal, depending on estimation of patient's point on Starling curve
Increase inotropy
Dobutamine +/- norepinephrine OR dopamine
Dobutamine may initially drop pressures, so may need to use second agent to maintain BP
Consider milrinone or beta-blocker reversal if patient is on a beta-blocker
Consider calcium chloride 1 g if hypocalcemic or normocalcemic through good PIV or central line
Consider transfusion if hemoglobin < 10 (be aware of added fluid)
Consider intubation
Decreases O2 demand BUT may worsen preload
Dobutamine +/- norepinephrine OR dopamine
Dobutamine may initially drop pressures, so may need to use second agent to maintain BP
Consider milrinone or beta-blocker reversal if patient is on a beta-blocker
Consider calcium chloride 1 g if hypocalcemic or normocalcemic through good PIV or central line
Dobutamine may initially drop pressures, so may need to use second agent to maintain BP
Decreases O2 demand BUT may worsen preload
Increase forward flow
Dobutamine (contractility) + nitroprusside (afterload reduction)
PCI or thrombolysis
Decrease afterload (with extreme caution in very small, carefully-titrated doses)
Agents:
Nitroprusside
Dobutamine
Hydralazine
Do not give preload reducers such as nitro
Patients are flow dependent over stenotic value.  Flow proportional to degree of stenosis and afterload.
Nitroprusside
Dobutamine
Hydralazine
Beta-Blocker Toxicity
Calcium Channel Blocker
 Digoxin
Cardiogenic shock
Cardiogenic
Undifferentiated shock 
Acute valvular Regurgitation/VSD
Undifferentiated shock
CHF
Neurogenic shock
Dysrhythmia