Chapter 12: Shock

DEFINITION

Shock is a condition of severe impairment of tissue perfusion leading to cellular injury and dysfunction. Rapid recognition and treatment are essential to prevent irreversible organ damage and death. Common causes are listed in Table 12-1.

TABLE 12-1: Categories of Shock
Distributive shock (profound decrease in systemic vascular tone) Sepsis Pancreatitis Anaphylaxis Neurogenic (e.g., spinal cord injury) Endocrine-related (Addison’s disease, myxedema)
Cardiogenic shock Myopathic (acute MI, fulminant myocarditis) Mechanical (acute severe mitral regurgitation, acute severe aortic insufficiency [e.g., aortic dissection], severe aortic stenosis, acute VSD) Arrhythmic
Obstructive shock Pericardial tamponade Massive pulmonary embolism Tension pneumothorax
Hypovolemic shock Hemorrhage GI losses (vomiting, diarrhea) Burns Polyuria (diabetic ketoacidosis, diabetes insipidus)

Abbreviation: VSD, ventricular septal defect.

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