Shock causes

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Causes

Life Threatening Causes

Shock is a life-threatening condition and must be treated as such irrespective of the underlying cause.

Common Causes

• Cardiogenic shock

• Arrhythmic

• Sinoatrial block
• Atrioventricular block
• Ventricular tachycardia
• Supraventricular tachycardia

• Mechanical

• Hypertrophic cardiomyopathy
• Acute mitral regurgitation
• Ventricular septal defect

• Myopathic

• Cardiomyopathy
• Myocardial contusion
• Myocardial infarction
• Myocarditis
• Postischemic myocardial stunning
• Septic myocardial depression
• Hypothyroidism

• Pharmacologic

• Anthracyclines
• Calcium channel blockers

• Obstructive shock

• Decreased cardiac compliance

• Cardiac tamponade
• Constrictive pericarditis
• Idiopathic
• Postinfarction free wall rupture
• Trauma
• Tumor
• Uremia

• Decreased ventricular preload

• Intrathoracic tumor
• Mechanical ventilation with positive end-expiratory pressure (PEEP)
• Tension pneumothorax

• Increased ventricular afterload

• Aortic dissection
• Pulmonary embolism
• Acute pulmonary hypertension
• Saddle embolus

• Hypovolemic shock

• Fluid depletion

• Dehydration
• Diarrhea
• Extensive burns
• Polyuria
• Vomiting
• Third spacing (as in endometritis, pancreatitis, peritonitis, pleural effusions)

• Hemorrhage

• Ectopic pregnancy
• Gastrointestinal bleeding
• Perforated peptic ulcer
• Post-procedural or post-surgical
• Retroperitoneal hemorrhage
• Rupture ovarian cyst
• Trauma

• Distributive shock

• Sepsis
• Toxic shock syndrome
• Anaphylactic or anaphylactoid reaction
• Neurogenic shock
• Adrenal crisis

Causes by Organ System

Cardiovascular	Acute ST elevation MI, Aortic dissection, Aortic stenosis, Arrhythmia, Cardiac tamponade, Cardiomyopathy, Constrictive pericarditis, Endocarditis, Hypertrophic cardiomyopathy, Myocarditis, Papillary muscle rupture, Valvular stenosis, Vena cava occlusion
Chemical/Poisoning	No underlying causes
Dental	No underlying causes
Dermatologic	No underlying causes
Drug Side Effect	Pramipexole, Theophylline
Ear Nose Throat	No underlying causes
Endocrine	Addisonian crisis, Hyperglycemia, Hyperthyroid coma, Hypoglycemia, Hypothyroid coma, Pheochromocytoma, Pituitary failure
Environmental	No underlying causes
Gastroenterologic	Ascites, Gastrointestinal bleeding, Gastrointestinal fluid loss, Hepatic failure, Mesenteric ischemia, Pancreatitis, Peritonitis
Genetic	No underlying causes
Hematologic	Blood transfusions
Iatrogenic	Overdrainage
Infectious Disease	No underlying causes
Musculoskeletal/Orthopedic	No underlying causes
Neurologic	Cerebrovascular accident, Craniocerebral trauma, Paraplegia, Spinal anesthesia
Nutritional/Metabolic	No underlying causes
Obstetric/Gynecologic	No underlying causes
Oncologic	No underlying causes
Ophthalmologic	No underlying causes
Overdose/Toxicity	No underlying causes
Psychiatric	No underlying causes
Pulmonary	Hemothorax, Pneumonia, Positive end-expiratory pressure (PEEP), Pulmonary embolism, Tension pneumothorax
Renal/Electrolyte	Polyuria
Rheumatology/Immunology/Allergy	Anaphylaxis, Anaphylactoid, Contrast media
Sexual	No underlying causes
Trauma	No underlying causes
Urologic	No underlying causes
Miscellaneous	Dehydration, Drugs, Insect bites, Retroperitoneal hemorrhage, Soft tissue hemorrhage, Visceral rupture

Causes in Alphabetical Order

• Acute ST elevation MI
• Addisonian crisis
• Anaphylaxis
• Aortic dissection
• Aortic stenosis
• Arrhythmia
• Ascites
• Blood transfusions
• Cardiac tamponade
• Cardiomyopathy
• Cerebrovascular accident
• Constrictive pericarditis
• Contrast media
• Craniocerebral trauma
• Dehydration
• Drugs

• Endocarditis
• Positive end-expiratory pressure (PEEP)
• Gastrointestinal bleeding
• Gastrointestinal fluid loss
• Hemothorax
• Hepatic failure
• Hyperglycemia
• Hyperthyroid coma
• Hypertrophic cardiomyopathy
• Hypoglycemia
• Hypothyroid coma
• Insect bites
• Mesenteric ischemia
• Myocarditis
• Overdrainage
• Pancreatitis

• Papillary muscle rupture
• Paraplegia
• Peritonitis
• Pheochromocytoma
• Pituitary failure
• Pneumonia
• Pneumonia
• Polyuria
• Pulmonary embolism
• Retroperitoneal hemorrhage
• Soft tissue hemorrhage
• Spinal anesthesia
• Tension pneumothorax
• Valvular stenosis
• Vena cava occlusion
• Visceral rupture

References

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