4. DEFINITION
Shock is a state in which diminished
cardiac output or reduced effective
circulating blood volume impairs tissue
perfusion and leads to cellular hypoxia.
OR
Shock is defined as a condition where the
tissue in the body do not receive enough
oxygen and nutrients to allow the cells to
function.

5. IF PROLONGED
 At the onset the cellular injury is
reversible however, prolonged shock
eventually leads to irreversible tissue
injury and is often fatal.

6. TYPES OF SHOCK
There are three major types of shock.
1. Cardiogenic shock
2. Hypovolemic shock
3. Septic shock
4. Anesthesia
5. Neurogenic shock (spinal cord injury)
6. Anaphylactic shock

7. CARDIOGENIC SHOCK
 Low cardiac output as a result of
myocardial pump failure leads to
severe heart attack.
 Due to this failure heart is unable to
supply enough blood to the vital organs
of the body.

8. Causes of cardiogenic
shock
1. MYOCARDIAL INFARCTION
2. ARRHYTHMIA
3. CARDIAC TAMPONADE (extrinsic
compression)
4. PULMONARY EMBOLISM (outflow
obstruction)
5. VENTRICULAR RUPTURE

9. MYOCARDIAL INFARCTION
 It is commonly known as a heart attack,
occur when blood flow decreases or
stops to a part of heart, causing damage
to the heart muscle.
 When the portion of heart is deprived of
oxygen due to blockage of a coronary
artery.

10. Myocardial infarction

11. ARRHYTHMIA
 Arrhythmia is an abnormal heart rhythm.
means heart beat is abnormal too fast or
too slow.

12. Cardiac tamponade
 Contraction of heart by accumulation of
fluid in pericardial sac.

13. Pulmonary embolism
 It is sudden blockage of major blood
vessel in the lungs usually by a blood
clot. In most cases the clots are small
and are not deadly but they can damage
the lung. But if the clot is large and stops
blood flow to the lung, it can be deadly.

14. PULMONARY EMBOLISM

15. Hypovolemic shock
 It is a life threatening condition that
results when body lose more than
20%of body’s blood or fluid supply.
 This severe fluid loss makes it
impossible for the heart to pump a
sufficient amount of blood to body and
can lead to organ failure.

16. Causes of hypovolemic
shock
1. Hemorrhage
2. Fluid loss such as
 Vomiting
 Diarrhea
 Burns
 Trauma
 Excessive sweating

17. Hemorrhage
 Escape of blood from ruptured blood
vessels.

18. Septic shock
 Septic shock is a serious medical condition
that occurs when sepsis, which is organ
injury or damage in response to infection
leads to dangerously low blood pressure
and abnormalities in cellular metabolism.
It is triggered by microbial infections and is
associated with severe systemic
inflammatory response syndrome (SIRS).
 SIRS is ‘‘INFLAMOTORY’’ response.

19. Diagram

20. CLINICAL EXAMPLES
1. Overwhelming microbial infection
2. Gram-negative sepsis
3. Gram-positive septicemia (blood poisoning
by bacteria)
4. Fungal sepsis
5. Superantigens (toxic shock syndrome)

21. SIRS
 SIRS are triggered by microbes, burns,
trauma or pancreatitis (inflammation of
pancrease).
 When microbes enter in cells cause
1. Arterial vasodilation
2. Vascular leakage
3. Venous blood pooling

22. Results of cardiovascular
abnormalities
 Hypoperfusion (decrease blood flow
through an organ)
 Hypoxia
 organ dysfunction
 If it is severe and persistent organ failure
and death.

23. NEUROGENIC SHOCK
 Spinal cord injury.

24. Anaphylactic shock
 It is systemic vasodilation and increased
vascular permeability that is triggered by
an immunoglobulin E-mediated
hypersensitivity reaction.
 Life threatening allergic reaction to
which the body has become
hypersensitive.

25. Anaphylactic shock

26. THANK YOU
(TOOBA IMRAN)