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