Obstructive Shock: Causes, Signs and Symptoms, & First Aid Management

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Obstructive shock is a medical emergency that occurs due to mechanical problems that averts diastolic filling resulting to decreased cardiac output.

Obstructive shock is a medical emergency that occurs to mechanical problems that avoids diastolic filling from occurring. This means that despite normal intravascular volume and myocardial function (heart pumping well), there are physical changes that lead to obstruction during diastolic filling of the ventricles, in contrast to biological or chemical changes. There is a decreased return to the heart due to an obstruction. Diastolic filling is the period of time when the heart refills after contraction (systole).

Decreased diastolic filling will result to reduced cardiac output. Consequently, there becomes an insufficient supply of blood to the different organs of the body. This may eventually lead to organ failure if this continues because blood carries oxygen and other essential substances that are necessary for proper functioning. Thus when the heart begins to fail pumping enough blood, symptoms of shock begin to show.

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Causes of Obstructive Shock

Evident from its name, obstructive shock occurs when there is a physical obstruction that prevents the heart from filling. The following may lead to obstructive shock:

  • Tension pneumothorax
  • Cardiac or pericardial tamponade
  • Massive pulmonary thromboembolism
  • Aortic dissection
  • Pulmonary or systemic hypertension (high blood pressures)
  • Congenital or acquired outflow obstructions, such as heart lesions
  • Vena cava syndrome

Signs and Symptoms of Obstructive Shock

Signs and symptoms of obstructive shock will vary depending on the extent of the damage. However, it must be noted that all symptoms of shock are fatal and must be treated as medical emergencies. Signs and symptoms of obstructive shock are similar to those of cardiogenic shock, which include:

  • Confusion or lack of alertness
  • Loss of ability to concentrate
  • Unconsciousness
  • Chest pain
  • Sudden, quick heartbeat but accompanied by a weak pulse
  • Little or no urine output
  • Excessive sweating
  • Pale, clammy skin
  • Rapid, shallow breathing
  • Dyspnea
  • Light-headedness
  • Cool hands and feet

First Aid Management for Obstructive Shock

Obstructive shock is a medical emergency. Call for emergency medical services or bring the victim to the nearest emergency room if an individual begins to show symptoms of obstructive shock. The victim should not drive himself/ herself due to the symptoms. Give first aid while waiting for the paramedics to arrive:

  • Check the victim’s circulation, airway and breathing. If necessary, begin rescue breathing and CPR.
  • Constant check rate of breathing every five minutes even if the victim is capable of breathing on his or her own.
  • If the victim is conscious with no injury to the head, neck, spine or leg, lay the person down flatly with the feet elevated about 12 inches to increase circulation. The head should not be elevated. This is called the shock position. Avoid moving the victim unless there is danger in the immediate environment.
  • If there is vomiting or drooling, turn the victim’s head to the side to avoid choking.
  • Loosen any tight clothing.

Disclaimer: This article does not provide medical advice and should not be substituted for formal training. The information given should not be used for self-diagnosis. Seek medical attention when necessary. It is important to recognise medical emergencies at all times to avoid complications from developing. To learn more about to how to treat and manage obstructive shock victims, sign up for American and Canadian first aid and CPR certification courses.


Chapter 29: Shock States. (ND). Expert Consult Retrieved October 16, 2013, from–s0160&isbn=978-0-323-07307-3

Meshkat, Nazanin. (2011). Shock. Global Health Emergency Medicine. Retrieved October 16, 2013, from,d.aGc


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