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. Hypovolemic shock an overview sciencedirect topics. The clinical presentation often is confusing, perhaps. Ppt shock powerpoint presentation, free download id. 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. Pathophysiology heart pumps well, but the output is. Your patients shock may be multifactorial, but mentally prioritize what you think is the main case of the shock, and deal with that first. Obstructive shock article about obstructive shock by the. Acsase medical student core curriculum shock shock is a life. In obstructive shock, its actually very similar except the.
Cardiogenic, obstructive, hypovolemic, and distributive. 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. Shock is a lifethreatening condition involving insufficient blood flow to the body tissues. Ppt obstructive shock powerpoint presentation free to. The four core types of shockcardiogenic, hypovolemic, obstructive, and vasoplegiccan readily be identified by echocardiography. 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. Obstructive shock cardiac tamponade arterial stanosis pulmonary embolus pulmonary htn constrictive pericarditis thoracic tumors tension pneumothorax indirect pump. See also the pulmccm topic, vasopressors for septic shock. Undifferentiated shock refers to the situation where shock is recognized but the cause is unclear. Pulmonary embolism and cardiac tamponade are considered forms of obstructive shock. 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.
If results of these tests are normal, the most likely causes include drug overdose, occult infection including toxic. It leads to distinctive symptoms and signs, initially of compensation and later of failure. Obstructive shock article about obstructive shock by. 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.
Septic shock, a form of distributive shock, is the most common form of. Hypovolemic shock is a lifethreatening condition, necessitating prompt diagnosis and therapy to prevent mof and death. The heart does not have the space to pump effectively. If blood flowing into the heart is obstructed, it causes a decrease in cardiac output because of impaired diastolic filling. A man in his 50s with no relevant medical history experienced rapidly progressive dyspnea over 2 days and presented to the ed.
Obstructive shock describes shock associated with vascular obstructive defects including pulmonary embolism, pericardial tamponade, atrial myxoma, tension pneumothorax, hydrothorax or haemothorax and even ascites. Obstructive shock differentiate from hypovolemic shock by signs and. Percutaneous ventricular assist device in hypertrophic. 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. Diagnosis of shock shock may be suspected based on the history given predation, vehicle.
From a hemodynamic viewpoint circulatory shock caused by obstruction is closely followed by cardiac deterioration. Obstructive shock is caused by the inability to produce adequate cardiac output. 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. Distributive shock septic shock anaphylactic shock neurogenic shock.
Circulatory shock boundless anatomy and physiology. Obstructive shock, pneumothorax, cardiac tamponade, pulmonary embolus. Loss of blood hemorrhagic shock external hemorrhage trauma gastrointestinal. The most simple physiology of shock is cardiogenic. Circulatory shock, commonly known simply as shock, is a lifethreatening medical condition that occurs due to the provision of inadequate substrates for cellular respiration. Hypovolemic shock is defined as the rapid fluid loss or. Obstructive shock occurs when the heart cannot work properl y for a physical reason. Obstructive shock is caused by obstruction the blood flow. Obstructive shock is a less common, but important cause of shock in critically ill infants and children. Obstructive shock is very similar to cardiogenic shock. Shock, obstructive symptoms, diagnosis, treatments and. 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. Obstructive shock has much in common with cardiogenic shock, and the.
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. Shock or its equivalent, by whatever name the era in question gave it, has been known since man came on the earth. Cardiovascular emergencies advanced life support successful treatment of cardiogenic shock involves minimizing the volume of fluid administered and early consideration of a vasopressor. Obstructive shock an overview sciencedirect topics. Obstructive shock definition of obstructive shock by. Causes include cardiac tamponade, pulmonary embolism and narrowing of the aortic artery. Obstructive shock is characterized by very low cardiac output and increased systemic vascular resistance. Pediatric considerations neonates consider congenital obstructive left heart syndrome as cause of obstructive shock oliguria shock2. To prioritize your interventions, remember how patients cohde. 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.
Obstructive shock as the name implies, is associated with obstruction of the heart or the great vessels. A man in his 50s presenting with rapidonset dyspnea and. Find powerpoint presentations and slides using the power of, find free presentations research about shock ppt. 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. Echocardiography in shock management critical care. Neurogenic shock is ruled out quickly by observing patients moving all their extremities. 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. Hypovolemic shock cardiogenic shock obstructive shock distributive shock. Obstructive shock cardiac tamponade andor tension pneumothorax should be reconsidered, and if any doubt remains, steps should be taken to correct this. Pulmonary embolism has a variable hemodynamic presentation depending on the clot burden and the extent of obstruction in the pulmonary vasculature.
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. 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. Training in echocardiography is essential for an intensivist. A free powerpoint ppt presentation displayed as a flash slide show on id.
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. Definition, classification, etiology, and pathophysiology of shock in. Find powerpoint presentations and slides using the power of, find free presentations research about hypovolemic shock ppt. The accumulation of blood outside the heart, but inside the sac of the heart, known as tamponade, is an example. Pathophysiology and management of different types of shock. Primitive men and women, in their struggle for existence, survived or died of shock from injury, trauma, hemorrhage and sickness. And thats actually why i have this heart drawn out right here. Treatment of obstructive shock the additional option for treatment of obstructive shock from pneumothorax is needle tho. Upon arrival, he was found to be in moderate distress. In cardiogenic shock, the problem is the heart is not able to squeeze properly and pump blood forward. 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. 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.
A collection of questions from content covered on the nclexrn. Obstructive shock circulatory system and disease nclex. Obstructive shock is a lifethreatening emergency that occurs when there is a problem with the functioning of the heart. Patients with no focal symptoms or signs indicative of cause should have ecg, cardiac enzymes, chest xray, and abgs. We present the case of a 69yearold woman with endstage hypertrophic obstructive cardiomyopathy who developed cardiogenic shock. When large numbers of cells are bypassed by oxygenated blood, an imbalance in oxygen demand and delivery develops that can lead to shock. View and download powerpoint presentations on shock ppt. In obstructive shock, its actually very similar except the issue here is its an obstruction. Distributive shock septic shock anaphylactic shock neurogenic shock 14. Obstructive shock is a form of shock associated with physical obstruction of the great vessels or the heart itself. View and download powerpoint presentations on hypovolemic shock ppt. The high dynamics of this potentially lifethreatening condition is a hallmark of all types of obstructive shock. In effect, there is inadequate effective cardiac output eco to provide the appropriate oxygen delivery. 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.