Obstructive Shock: Causes, Symptoms & Treatment

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  • 0:04 Medical Emergency
  • 0:39 What Is Obstructive Shock?
  • 1:14 Causes of Obstructive Shock
  • 2:11 Symptoms of Obstructive Shock
  • 3:07 Treatment for…
  • 5:10 Lesson Summary
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Lesson Transcript
Instructor: Alexandra Unfried

Alexandra earned her master's degree in nursing education and is currently a hospital supervisor/administrator.

Obstructive shock is a life-threatening emergency that occurs when there is a problem with the functioning of the heart. This lesson discusses the causes, symptoms, and treatment of obstructive shock.

Medical Emergency

Dave is a sixty-five-year old man who has a history of an aortic aneurysm. He has been followed closely by his doctor to monitor the condition. He's taking medications and has been trying to alter his lifestyle to make healthier choices. However, Dave recently went on vacation and forgot his medications, ate a bad diet, and was not paying attention to his health. Dave is now having severe chest pain and shortness of breath. He's at home with his wife and suddenly loses consciousness. Dave's wife immediately calls for an ambulance.

What Is Obstructive Shock?

Obstructive shock is a medical emergency. It happens when there is a decrease in diastolic filling of the heart, which then decreases cardiac output. This means that the heart is not getting enough blood to pump out to the rest of the body. The decreased amount of blood getting to the heart is caused by an obstruction. Shock then occurs due to the lack of blood getting to the organs and decreasing their functioning capacity.

The paramedics arrive at Dave's house, and his wife tells them his medical history. The paramedics think Dave might be experiencing some form of shock based on his symptoms and history.

Causes of Obstructive Shock

As previously stated, obstructive shock occurs when there is an obstruction, which causes a decreased amount of blood to get to the heart. Several diseases or disorders can cause obstructive shock, such as:

  • Aortic dissection: the large blood vessel attached to the heart tears and cannot transport blood to and from the heart effectively

  • Tension pneumothorax: air leaks out of the lungs due to trauma

  • Vena cava syndrome: a major vein in the body becomes blocked and cannot carry blood from the body to the heart

  • High blood pressure: pulmonary or systemic hypertension

  • Pulmonary embolism: blood clot in the lungs

  • Heart lesions: obstruct the flow of blood from the heart

  • Cardiac tamponade: a pressure on the heart that keeps it from filling, which decreases blood pressure

The paramedics think that Dave's aortic aneurysm has dissected and is causing obstructive shock. They continue to assess for symptoms so they can begin proper treatment.

Symptoms of Obstructive Shock

The symptoms of obstructive shock are considered emergencies because they can lead to organ failure, tissue death, and death.

  • Symptoms that are associated with neurological function include confusion, loss of consciousness, and inability to concentrate.

  • The symptoms that are related to the heart and its function are chest pain, lightheadedness, and a sudden increase in heart rate along with a faint pulse.

  • Respiratory symptoms consist of shortness of breath and fast but shallow breathing.

  • Other symptoms include sweating, decreased urine output, clammy skin, pallor, and cold hands and feet.

Dave is having several more symptoms as he is being assessed. Along with his chest pain, shortness of breath, and loss of consciousness the paramedics see an increased heart rate with a thready pulse, shallow breathing, sweating, and clammy skin. Initial treatment of shock is started as they prepare to transport Dave to the hospital where his aortic dissection will be addressed.

Treatment for Obstructive Shock

The main treatment for obstructive shock is to treat the cause. However, initial treatment is the same for most types of shock, which involves giving a large amount of intravenous fluids very quickly and giving medications that will increase the blood pressure to increase blood flow to the rest of the body and organs. The commonly used medications are epinephrine, norepinephrine, and dopamine. The cause of shock is then treated in order to restore the body back to a functioning state.

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