Pathophysiology

of
Shock
Definition…
Shock is an ACUTE
CIRCULATORY CRISIS marked
by low blood pressure
(hypotension) and inadequate
peripheral blood flow.
Common causes of shock

2. A drop in cardiac output after

hemorrhaging or other fluid losses (like in
diarrhea and vomiting).
3. Damage to the heart (As in Myocardial
Infarction).
4. External pressure on the heart.
5. Extensive peripheral vasodilatation.
SYMPTOMS of circulatory
shock
Appear after fluid losses of about 30
percent of the
total blood volume. six basic symptoms:
Hypotension.
A rise in heart rate and a rapid,
weak pulse.
Pale, cool, and moist (“clammy”)
skin.
confusion and disorientation
A cessation of urination
A drop in blood pH (acidosis)
Note that
In mild forms of circulatory shock,
homeostatic ad­justments can cope with
the situation.
When blood volume declines by more
than 35 percent, homeostatic
mechanisms are no longer able to cope
with the situation.
A vicious cycle begins when the low
cardiac output damages the
myocardium. This damage leads to a
further reduction in cardiac output and
subsequent reductions in blood pressure
and venous return.
In mild forms of circulatory
shock, homeostatic
adjustments can cope with
the situation.
When blood volume
declines by more than 35
percent, homeostatic
mechanisms are no longer
able to cope with the
situation.
A vicious cycle begins when
the low cardiac output
damages the myocardium. This
damage leads to a further
reduction in cardiac output and
subsequent reductions in blood
pressure and venous return. As
the blood flow to the brain
decreases, the individual
Treatment must concentrate on
(1) preventing further fluid losses and
(2) giving a transfusion of whole blood,
plasma expanders, or blood substitutes.
Irreversible shock begins when
conditions in the tissues become so
abnormal that the arteriolar smooth
muscles and pre-capillary sphincters
become unable to contract, despite the
commands of the vasomotor centers.
The result is a widespread peripheral
vasodilatation and an immediate and fatal
decline in blood pressure. This event is
called circulatory collapse.