User:Ailenilin/Obstructive Shock

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As in all types of shock, low blood pressure is a key finding in patients with obstructive shock. In response to low blood pressure, heart rate increases. Shortness of breath, tachypnea, and hypoxia may be present. Because of poor blood flow to the tissues, patients may have cold extremities. Less blood to the kidneys and brain can cause decreased urine output and altered mental status, respectively.

Other signs may be seen depending on the underlying cause. For example, jugular venous distension is a significant finding in evaluating shock. This occurs in cardiogenic and obstructive shock. This is not observed in the other two types of shock, hypovolemic and distributive. Some particular clinical findings are described below.

A classic finding of cardiac tamponade is Beck's triad. The triad includes hypotension, jugular vein distension, and muffled heart sounds. Kussmaul's sign and pulsus paradoxus may also be seen. Low-voltage QRS complexes and electrical alternans are signs on EKG. However, EKG may not show these findings and most often shows tachycardia.

Tension pneumothorax would have decreased breath sounds on the affected side. Tracheal deviation, which describes the displacement of the trachea from its anatomically correct position due to an expansion of air in the mediastinum, may also be present when it is shifted away from the affected side and occurs as an urgent sign of the condition that has evolved over a late period of time. Thus, a lung exam is important. Other findings may include decreased chest mobility and air underneath the skin (subcutaneous emphysema).

Pulmonary embolism similarly presents with shortness of breath and hypoxia. Chest pain worse with inspiration is frequently seen. Chest pain can also be similar to a heart attack. This is due to the right ventricular stress and ischemia that can occur in PE. Other symptoms are syncope and hemoptysis. DVT is a common cause. Thus, symptoms including leg pain, redness, and swelling can be present. The likelihood of pulmonary embolism can be evaluated through various criteria. The Wells score is often calculated. It gives points based on these symptoms and patient risk factors