ETIOPATHOGENESIS OF SHOCK

Resource faculty : Dr.Niharika Shah

Moderator : Dr.Amrendra Jha
Presenter : Nuppur Thapa
CONTENTS
 Definition
 Classification
 Etiopathogenesis of each type
 Pathogenesis at cellular level
 Overview
SHOCK Oxygen
supply

Oxygen
demand

 State at which the decreased cardiac output or the

reduced effective circulatory blood volume leads to
tissue hypoperfusion and hypoxia
 Systemic hypotension →tissue hypoperfusion
→multiple organ failure
 CLASSIFICATION

Based on pathophysiology :
Distributi
Distributi

Cardiogen
Cardiogen
veve

ic
ic

SHOCK

Hypovole
Hypovole
e

mic
e
Obstructiv

mic
Obstructiv
 DISTRIBUTIVE SHOCK

Example:

 Septic shock
 Anaphylatic shock
 Neurogenic shock
Septic shock

 gram positive organism

 gram negative organism

 Fungi

 Viral infection( SARS CoV2)

Shock  Among all,septic shock is predominant

in covid  67%of the covid patient in ICU
19  Either due to virus itself or secondary infection
PATHOGENESIS OF SEPTIC SHOCK
Neurogenic shock

Parasympathetic

Sympathetic
activation

inhibition
Massive vasodilatation
 Etiology:
↓SVR
 Spinal injury
 Brain damage Inadequate CO
 Anesthetic accidents
Tissue hypoperfusion

Hypoxia
o Anaphylactic shock

Causes:
 Food

 Drugs (penicillin)

 Insect bites/wasp sting

Pathogenesis:
IgE mediated hypersensitivity
OBSTRUCTIVE SHOCK

Pulmonary embolism Cardiac tamponade Aortic dissection

Blood
flow
Tissue
hypope
Hyp
obstructi
on rfusion oxia
CARDIOGENIC SHOCK

 Cardiac problems: Pump failure

 Myocardial infarction
↓Cardiac output
 Arrythmias
 Valvular diseases
Tissue hypoperfusion

Hypoxia
HYPOVOLEMIC SHOCK

 Causes
Loss of circulating
volume
 hemorrhages
 GI loss
↓Venus return &
 burn preload

 Polyuria
↓Cardiac output
Diabetic ketoacidosis
Diabetic insipidius
systemic hypotension

Perfusion failure

Hypoxia
PATHOGENESIS AT CELLULAR LEVEL
OVERVIEW
↓Effective circulatory
volume
Hypovolemia

↓Venous return

Sepsis
↓Cardiac output
Blood flow
obstruction ↓Blood flow and O2
supply
Cardiac problems

SHOCK
REFERENCE

 Robbins and Cotrans pathology -9th edition

 Harrison Principles of internal medicine-20th edition

 Cleveland clinical journal of medicine

 H.-Y. Lin / Chinese Journal of Traumatology 23 (2020) 190e19

THANK YOU