Cardiac shock Flashcards
Describe the relationship between cardiac function equation and the type of shock
Cardiogenic shock
- Loss of contractility REDUCES STROKE VOLUME
–> Resulting in INCREASE ESV
–> SVR increased, pulse pressure decreases (increased diastoic pressures)
- COMPENSATORY MECHANISMS SIMILAR TO HYPOVOLEMIC shock
Hypovolemic shock
- BLOOD/VOLUME LOSS DECREASE in END DIASTOLIC VOLUME
–> causes in increase in SVR
–> pulse pressure decreased (increased diastolic pressure)
–> Eg. traumatic hemorrhage, burn, vomtiing, diarrhea, ascites, decreased intake
describe the compensatory mechanisms for Hypovolemic shock
- Baroreflex activated, generalized sympathetic activity (cutaneous circulation impaired, skin is cool and pale, reflex thirst activation, sweating)
- tachycardia
- icnreased secretion of vasopression, glucocorticoids, renin and aldosterone, erythropoietin
- increased plasma protein synthesis
Describe anaphylactic shock
- DISTRIBUTIVE SHOCK
- Bronchospams REDUCES VENTILATION and blood pressure is low (systemic vasodilation)
- EPI, with histamine blockers and steroid treament and removal of antigen
What are the types of DISTRIBUTIVE SHOCK
- Anaphylactice
- septic
- neurogenic
- drug-induced vasodialtion
Types of cardiogenic shock
- Dysrhythmia (bradycardia, tachycardia)
- cardiomyopathy (infarction, dilation)
- Mechanical (valvular, rupture)
types of obstructive shock
- Tension pneumothorax
- pericardial disease
- pulmonary embolism
describe septic shock
- DISTRIBUTIVE SHOCK
- Sepsis –> severe sepsis –> septic shock
–> COmplications of infections, exaggerated inflammaotyr response (SIRS)
–> high temp. high HR, high RR, high WBC
–> LOW SVR (reflex mechanisms activated but then eventually fails
describe neurogenic shock
- DISTRIBUTIVE SHOCK
- Spinal lesion leads to HYPOTENSION (loss of vascular tone)
–>loss of autonomic ganglia reduce reflex tachy
–> venous pooling
–> syncope
Describe Drug-induced vasodilation
- DISTRIBUTIVE SHOCK
–> Beta-BLockers and calcium channel blocker overdose/overuse –> hypotension
–> anesthetic (spinal)
SYMPTOMS = low BP and warm skin
describe OBSTRUCTIVE SHOCK
- TENSION PNEUMOTHORAX, pericardial tamponade, and massive PE –> cause impaired ventricular filling and CO
Tension penumothorax = unilateral decreased breath sounds
pericardial tamponade = low BP, elevated right heart pressure
PE = chest pain, syncope, tachypnea, hypotension with right ventricular overload (JCD, ECG)
** DONT INCREASE FLUID, FURTHER COMPROMISE HEART FUNCTION**
describe decompensated shock
- Reduction in MEAN ARTERIAL PRESSURE is decreasing blood flow to organs
–> sympathetic is turned on to INCREASE cardiac function by vasoconstriction and increasing resistance
–> causes reduced blood flow in organ systems –> each organ is trying to save itself
–> causes more chagnes in venous tone
–> further reducing cardiac output and total peripheral resistance which creates a further eduction in mean arterial pressure
–> radical stress due to tissue hypoxia results in increasing nitric oxide production causing VASODILATION which DECREASES TOTAL PERIPHERAL RESISTANCE
describe irreversible shock
- Once in shock for long enough, it eventually becomes IRREVERSIBLE (cannot come back from it)
–> so much damage has been done by reduciton intotal peripheral reistance due to cell death, and radical stress (loss of autonomic vascular regulation due to local nitric oxide)
- RESTORATION OF BLOOD VOLUME (HYPOVOLEMIC SHOCK) cannot rescue tissue damage
