Cardiovascular shock
Cardiovascular shock
Inadequate supply of O2 to the tissues
Results in loss of tissue function and loss of corrective reflexes
Note: especially the heart & nervous system
PROBLEMS PRESENTED BY SHOCK
• decreased cardiac output
• decreased VR !!!
• loss of sympathetic reflexes
• tissue dehydration ( BP)
• renal failure
Shock
• Anaphylactic
• Cardiogenic
• Emotional stress
• Hemorrhagic
• Also burns
SYMPTOMS:
• Cold, clammy skin
• Rapid shallow pulse
• Dilated pupils
• Loss of pupillary reflex
• Edema
Treatments
• Elevate feet
• Keep warm
• Plasma expanders
• Epinephrine
Reversible – NonReversible Border:
Oxygen deficit of > 120 ml/Kg body weight
HYPERTENSION
see Box on page 450
• Increased TPR
• “Essential” or idiopathic
• Atherosclerosis
• Decreased arterial compliance
• Arteriosclerosis
• plaque deposit in major vessel
POSITIVE FEEDBACK
Increased TPR --> increased cardiac work
---> Increased cardiac muscle mass (hypertrophy)
---> Increased bv muscle mass & TPR
Increased cardiac O2 demand !!!
Also
Decreased BV compliance over time
Made worse by ‘re-setting’ of the baroreceptors as the BVs lose their compliance
Potential problems
• Myocardial disease
• Heart attack and infarct
• ---> increased work for remaining healthy tissue
• Decreased VR ----> edema
• Liver
• Lungs
• Kidney
• Edema
Swelling of the tissues due to fluid accumulation from the capillaries
Increased BP in tissues
Decreased VR
Increased TPR
Possible Treatments
• Vasodilators
• “False NTs” - α− methyl DOPA
• Diuretics
•
← Blockers
• Sedatives
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