Search
obstructive shock
Etiology:
1) pulmonary embolism with acute cor pulmonale
2) cardiac tamponade
3) tension pneumothorax
4) atrial myxoma
5) acute valvular stenosis
a) thrombosis of prosthetic valve
b) prosthesis malfunction
6) aortic dissection with obliteration of true lumen Pathophysiology
1) increased central venous pressure
2) decreased left ventricular filling pressure or left ventricular outflow obstruction
3) hypotension
4) tachycardia
5) low cardiac output
Management:
1) supportive
- volume expansion
- vasopressors
2) specific treatment of mechanical problems
a) pericardiocentesis
b) chest tube placement
c) thrombolytic therapy
- massive pulmonary embolus
- valve thrombosis
d) embolectomy
e) cardiac surgery.
General
shock
References
- Manual of Medical Therapeutics, 28th ed, Ewald &
McKenzie (eds), Little, Brown & Co, Boston, 1995, pg 137
- Saunders Manual of Medical Practice, Rakel (ed), WB Saunders,
Philadelphia, 1996, pg 212-214
- Medical Knowledge Self Assessment Program (MKSAP) 17,
American College of Physicians, Philadelphia 2015