Shock is a topic covered in the Harrison's Manual of Medicine.

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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 11-1.


Hypovolemic shock

  •  Hemorrhage
  •  Intravascular volume depletion (e.g., vomiting, diarrhea, ketoacidosis)
  •  Internal sequestration (ascites, pancreatitis, intestinal obstruction)

Cardiogenic shock

  •  Myopathic (acute MI, fulminant myocarditis)
  •  Mechanical (e.g., acute mitral regurgitation, ventricular septal defect, severe aortic stenosis, aortic dissection with aortic insufficiency)
  •  Arrhythmic

Extracardiac obstructive shock

  •  Pericardial tamponade
  •  Massive pulmonary embolism
  •  Tension pneumothorax

Distributive shock (profound decrease in systemic vascular tone)

  •  Sepsis
  •  Toxic overdoses
  •  Anaphylaxis
  •  Neurogenic (e.g., spinal cord injury)
  •  Endocrinologic (Addison’s disease, myxedema)

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