In obstructive shock, its actually very similar except the. The most simple physiology of shock is cardiogenic. Cardiogenic, obstructive, hypovolemic, and distributive. Neurogenic shock is rare, and its diagnosis is commonly delayed. Obstructive shock definition of obstructive shock by. Primitive men and women, in their struggle for existence, survived or died of shock from injury, trauma, hemorrhage and sickness. Diagnosis of shock shock may be suspected based on the history given predation, vehicle. In obstructive shock, its actually very similar except the issue here is its an obstruction. If blood flowing into the heart is obstructed, it causes a decrease in cardiac output because of impaired diastolic filling. Obstructive shock differentiate from hypovolemic shock by signs and. Shock or its equivalent, by whatever name the era in question gave it, has been known since man came on the earth.
Circulatory collapse caused by conditions that block the flow of blood into or out of the heart, such as cardiac tamponade, cardiac tumors, massive pulmonary embolism, or tension pneumothorax. Distributive shock septic shock anaphylactic shock neurogenic shock. Typical symptoms of shock include elevated but weak heart rate, low blood pressure, and poor organ function, typically observed as low urine output, confusion, or loss of consciousness. The heart does not have the space to pump effectively. The four core types of shockcardiogenic, hypovolemic, obstructive, and vasoplegiccan readily be identified by echocardiography. We present the case of a 69yearold woman with endstage hypertrophic obstructive cardiomyopathy who developed cardiogenic shock. Circulatory shock, commonly known simply as shock, is a lifethreatening medical condition that occurs due to the provision of inadequate substrates for cellular respiration.
Shock is a clinical state in which disparity of oxygen supply and demand at cell level results in tissue hypoxia and incipient failure of cell function. Now, this will be an advanced coverage of all the different types of shock, so most of my detail will be very brief, and give you a. Cardiovascular emergencies advanced life support successful treatment of cardiogenic shock involves minimizing the volume of fluid administered and early consideration of a vasopressor. Shock is a lifethreatening condition involving insufficient blood flow to the body tissues. Echocardiography in shock management critical care. A collection of questions from content covered on the nclexrn. Obstructive shock is a less common, but important cause of shock in critically ill infants and children. A free powerpoint ppt presentation displayed as a flash slide show on id. Ppt shock powerpoint presentation, free download id. Hypovolemic shock is a lifethreatening condition, necessitating prompt diagnosis and therapy to prevent mof and death. Causes include cardiac tamponade, pulmonary embolism and narrowing of the aortic artery. Definition, classification, etiology, and pathophysiology of shock in.
The major cause of unstability in polytrauma patients diagnosed by rush is hypovolemic shock 64%, followed by obstructive, whose second and third causes are respectively cardiogenic shock and. Pulmonary embolism and cardiac tamponade are considered forms of obstructive shock. Find powerpoint presentations and slides using the power of, find free presentations research about shock ppt. Loss of blood hemorrhagic shock external hemorrhage trauma gastrointestinal. Obstructive shock article about obstructive shock by. The high dynamics of this potentially lifethreatening condition is a hallmark of all types of obstructive shock. Undifferentiated shock refers to the situation where shock is recognized but the cause is unclear. Obstructive shock article about obstructive shock by the. Pediatric shock recognition, classification and initial management critical concepts course recognition and classification initial management of shock final thoughts recognize compensated shock quickly have a high index of suspicion, remember tachycardia is an early sign. It leads to distinctive symptoms and signs, initially of compensation and later of failure. Obstructive shock is characterized by very low cardiac output and increased systemic vascular resistance.
Obstructive shock cardiac tamponade arterial stanosis pulmonary embolus pulmonary htn constrictive pericarditis thoracic tumors tension pneumothorax indirect pump failure pathophysiology and etiology risk factors clinical manifestation collaboration the who, what, where, and when diagnostic test pharmacologic therapies clinical therapies. Ppt obstructive shock powerpoint presentation free to. Circulatory shock boundless anatomy and physiology. Percutaneous ventricular assist device in hypertrophic. The clinical presentation often is confusing, perhaps. When large numbers of cells are bypassed by oxygenated blood, an imbalance in oxygen demand and delivery develops that can lead to shock. Acsase medical student core curriculum shock shock is a life. See also the pulmccm topic, vasopressors for septic shock. Obstructive shock an overview sciencedirect topics. Obstructive shock, pneumothorax, cardiac tamponade, pulmonary embolus.
Pulmonary embolism has a variable hemodynamic presentation depending on the clot burden and the extent of obstruction in the pulmonary vasculature. Obstructive shock is very similar to cardiogenic shock. Upon arrival, he was found to be in moderate distress. If results of these tests are normal, the most likely causes include drug overdose, occult infection including toxic.
Despite new insights into pathophysiology and new horizons for treatment, the main principles of management remain the rapid and complete repletion of circulating blood volume and treatment of the. Your patients shock may be multifactorial, but mentally prioritize what you think is the main case of the shock, and deal with that first. Objective of the study was to appreciate prevalence and main clinical features of obstructive shock os in patients with pe admitted to our departement, and to evaluate thrombolytic therapy effectiveness bape regimen. Septic shock, a form of distributive shock, is the most common form of. Even within each of the main headings contained in the shock classification, a variety of pathologies may be the cause and echocardiography will differentiate which of these is responsible. Pathophysiology heart pumps well, but the output is decreased due to an obstruction in or out of the heart map co x svr hr x stroke volume if the blood outflow from the heart is decreased because there is decreased return to the heart due to an obstruction or obstructed as the blood leaves the heart the stroke. To prioritize your interventions, remember how patients cohde. Pediatric considerations neonates consider congenital obstructive left heart syndrome as cause of obstructive shock oliguria shock2. Pathophysiology heart pumps well, but the output is. Hypovolemic shock is defined as the rapid fluid loss or. A man in his 50s presenting with rapidonset dyspnea and. Anand kumar, md section of critical care medicine section of infectious diseases university of manitoba, winnipeg, canada umdnjrobert wood johnson medical school cooper hospital, nj shock pathophysiology, classification, and approach to management.
Pathophysiology and management of different types of shock. Obstructive shock cardiac tamponade arterial stanosis pulmonary embolus pulmonary htn constrictive pericarditis thoracic tumors tension pneumothorax indirect pump. Distributive shock septic shock anaphylactic shock neurogenic shock 14. From a hemodynamic viewpoint circulatory shock caused by obstruction is closely followed by cardiac deterioration.
Shock, obstructive symptoms, diagnosis, treatments and. Hypovolemic shock an overview sciencedirect topics. View and download powerpoint presentations on hypovolemic shock ppt. Obstructive shock describes shock associated with vascular obstructive defects including pulmonary embolism, pericardial tamponade, atrial myxoma, tension pneumothorax, hydrothorax or haemothorax and even ascites. It is caused by mechanical obstruction of blood flow to andor from the heart and causes can include a tension pneumothorax, cardiac tamponade, pulmonary embolus, or cardiac defects resulting in leftsided outflow tract obstruction. And thats actually why i have this heart drawn out right here. A man in his 50s with no relevant medical history experienced rapidly progressive dyspnea over 2 days and presented to the ed.
In cardiogenic shock, the problem is the heart is not able to squeeze properly and pump blood forward. Septic shock, a form of distributive shock, is the most common form of shock among patients admitted to the intensive care unit, followed by cardiogenic and. Treatment of obstructive shock the additional option for treatment of obstructive shock from pneumothorax is needle tho. Obstructive shock as the name implies, is associated with obstruction of the heart or the great vessels. The four takehome points in the approach to shock in children. Obstructive shock is a form of shock associated with physical obstruction of the great vessels or the heart itself.
Obstructive shock is a lifethreatening emergency that occurs when there is a problem with the functioning of the heart. She underwent emergent placement of a percutaneous left ventricular assist device tandemheart in the catheterization lab as a bridge support device until a septal myectomy could be performed as definitive treatment. The accumulation of blood outside the heart, but inside the sac of the heart, known as tamponade, is an example. Obstructive shock occurs when adequate oxygen and nutrient delivery to the organs and tissues of the body is compromised as a direct result of an obstruction to blood flow into or out of the heart. Patients with no focal symptoms or signs indicative of cause should have ecg, cardiac enzymes, chest xray, and abgs. Obstructive shock is when a person goes into shock as a result of an obstruction or blockage or the great blood vessels such as the aorta, or of the heart itself. Obstructive shock cardiac tamponade andor tension pneumothorax should be reconsidered, and if any doubt remains, steps should be taken to correct this.
We present a rapidly fatal case of obstructive shock where a vigilant intensivist could diagnose left atrial mass obstructing the mitral inflow as the etiology of shock. Find powerpoint presentations and slides using the power of, find free presentations research about hypovolemic shock ppt. Obstructive shock is caused by obstruction the blood flow. So, i want to create one final video on shock, and this is the video to really compare all the different types of shock, and see how you can differentiate between them. Hypovolemic shock cardiogenic shock obstructive shock distributive shock. Obstructive shock is caused by some sort of significant blockage in blood flow, usually near either the heart or lungs pulmonary circulation, which leads to low blood pressure and eventual organ. Obstructive shock circulatory system and disease nclex. Groeneveld, in critical care medicine third edition, 2008. Obstructive shock occurs when the heart cannot work properl y for a physical reason. Obstructive shock is caused by the inability to produce adequate cardiac output. Neurogenic shock is ruled out quickly by observing patients moving all their extremities.
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