1. The document discusses the different types of shock including hypovolemic, cardiogenic, neurogenic, anaphylactic, septic, and endocrinal shock. 2. It provides definitions and key clinical signs for each type of shock. For example, hypovolemic shock occurs when there is a sudden loss of blood or fluids, leading to signs like tachycardia and decreased blood pressure. 3. The clinical signs of different shock types are compared, showing how factors like cardiac output and blood pressure can help distinguish between them.

1. Clinical picture of different types of
shock
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2. shock
hypovolemic cardiogenic neurogenic anaphylactic septic endocrinal
 clinical picture differences between different types
of shock
1- Hypovolemic shock:i
 Clinical signs:
definition
hypovolemic shock occurs when there is a sudden & significant
loss of blood or body fluids >>> blood volume drops
•mild tachycardia
•orthostatic hypotension
•anxiety
•sweating
•pallor
early signs
•depressed mental status (loss of consciousness)
•decreased blood pressure
•marked tachycardia
•decreased CVP
late signs

3. 2- Cardiogenic shock:
 Clinical signs:ii
definition
the heart can't pump enough blood to meet all body's needs
>> inadequate blood flow to vital organs (although blood
volume may be normal)
•compensatory peripheral vasoconstriction >>> cold sweaty skin
drop in systolic & diastolic pressure
inadequate tissue perfusion
metabolic acidosis increases
congested neck veins
high central venous pressure (CVP)
•to meet organ's oxygen needs
tachypnea
tachycardia
pale skin & sweating
loss of consciousness

4. definition
it is a consequence of spinal cord injury >> loss of
sympathetic tone (vasomotor fibers paralysis) >> pooling of
blood in the peripheries >> inadequate venous return
definition
it is a severe allergic reaction upon exposure to a specific
antigen >> massive histamine-mediated vasodilation and
maldistribution &
3- Neurogenic shock:iii
 Clinical signs:
 Note:
4- Anaphylactic shock:iv
hypotension bradycardia
warm dry
skin
nausea &
vomiting
temperature
dysregulation
dizziness
tachycardia
• hypovolemic shock
• obstructive shock
• cardiogenic shock
• septic shock
bradycardia • neurogenic shock

5.  Clinical signs:
5-Septic shock:v
 Clinical signs:
 Note:
bronchospasm
Laryngeal
spasm
Respiratory
distress
Hypotension
(due to
massive
vasodilation)
loss of
consciousness
cyanosis
definition
it is a dysregulated response by the body to an infection
resulting in life-threatening organ dysfunctions
• restlessness & confusion
• fever (above 38 ͦC) & chills
• mild reduction in blood pressure
• tachypnoea
• tachycardia
• patient is flushed with warm dry extremities
• oliguria
• elevated cardiac output
early signs
• systolic blood pressure <90 mmHg
• tachycardia & tachypnoea
• cold clammy skin
• oliguria
• multiple organ failure starts at this stage
late signs
Hyperdynamic (warm) septic shock -----------------------> Hypodynamic(cold)septic shock
If not treated efficiently
patient will develop a picture similar to that of hypovolaemic shock with reduced cardiac output

6. 6- Endocrinal shock:
 examples:
clinical signs:
definition
it is caused by disturbances in the endocrine
system
Addison's
disease + stress
(infection,
surgery...)
failure of the
body to release
corticosteroids
needed to cope
with the stress
severe
hypothyroidism
thyrotoxicosis
severe adrenal
insufficeincy
profound weakness
slow sluggish movements
nausea & vomiting
low blood pressure
tachycardia
confusion & slurred speech
flank pain
tachypnoea
convulsions may also occur
>> uncontrolled chills

7. summing up:
Shock type Hypovolemic Cardiogenic Septic
Cardiac output decreased reduced Normal or
increased
Pulmonary
capillary
wedge
pressure
low increased Normal or
decreased
CVP decreased increased Increased or
reduced
Blood
pressure
low low low
Systemic
vascular
resistance
increased increased Reduced
i
https://www.webmd.com/a-to-z-guides/hypovolemic-shock#1
ii
https://www.mayoclinic.org/diseases-conditions/cardiogenic-shock/symptoms-causes/syc-
20366739
iii
Dave S, Cho JJ. Neurogenic Shock. [Updated 2020 Mar 28]. In: StatPearls [Internet].
Treasure Island (FL): StatPearls Publishing; 2020 Jan
iv
Standl T, Annecke T, Cascorbi I, Heller A, Sabashnikov A, Teske W. The nomenclature,
definition and distinction of types of shock. Deutsches Aerzteblatt Online. 2018
v
Hotchkiss R, Moldawer L, Opal S, Reinhart K, Turnbull I, Vincent J. Sepsis and septic shock.
Nature Reviews Disease Primers. 2016;2(1).