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Obstructive shock is caused by some sort of significant blockage in blood flow, usually near either the heart or lungs (pulmonary circulation), which leads to low blood pressure and eventual organ failure.[1] Shock caused by obstruction is life threatening and typically ends with cardiac failure (heart attack) and death. As such, being able to quickly spot obstructive shock symptoms is important in order to get emergency medical treatment.

Part 1 of 2:
Recognizing the Most Common Symptoms

  1. 1
    Look for symptoms related to the skin. Signs and symptoms of obstructive shock begin to show when the heart fails to pump enough blood to the rest of the body. Some of the first signs that are noticeable involve the skin, such as excessive sweating, clamminess, reduced temperature and a general paleness.[2]
    • If the skin looks pale and feels clammy, touch the fingers and toes to see if they're chilly. That's a good indication that there's a circulation problem.
    • A lack of oxygen to tissues can make the skin look pale, but also with a bluish tint — a condition called cyanosis.
  2. 2
    Watch for changes in brain function. Another set of signs and symptoms common with obstructive shock are related to brain function and consciousness. Reduced blood and oxygen to the brain quickly leads to lightheadedness, confusion, problems concentrating, anxiety, restlessness and loss of consciousness (ultimately).[3]
    • Any problem involving a blockage of blood (heart attack, stroke, pulmonary embolism, severe atherosclerosis) will cause similar behaviors and impairments.
    • If you sense any of these symptoms in someone else, carry on a short conversation with them — they won't make any sense if they are experiencing obstructive shock.
  3. 3
    Check for weak pulse and low blood pressure. As the heart or surrounding major blood vessels (aorta, vena cava) are unable to pump enough blood to the body, the pulse and pressure in the cardiovascular system drops.[4] Low blood pressure (hypotension) contributes to lightheadedness and dizziness, especially when trying to stand up from a seated or horizontal position.
    • Although blood pressure varies from person to person, a reading of 90 / 60 mmHg or less is generally considered hypotension.[5]
    • The best places to feel for a pulse are the inside wrist, inside part of the ankle and the neck close to the jaw line. A strong pulse is obvious; a weak pulse is barely detectable.
  4. 4
    Listen for rapid, shallow breathing. Due to a weak heartbeat and pulse, the body increases the breathing rate in attempts to get enough oxygen into the blood so the cells, tissues and organs don't start to die. However, the breathing isn't deep like it would be if the person was simply winded — instead it's shallow and rapid. This kind of breathing quickly leads to a dry mouth and thirst.[6]
    • Look at the chest (or lightly touch it) to see if it's rising and falling quickly, which indicates rapid and shallow breathing.
    • Hold your ear close to the person's mouth to better detect if their breathing is rapid and shallow.
    • A normal respiration rate for a calm adult is between 12 to 20 breaths per minute — above 25 is considered abnormal.[7]
  5. 5
    Take notice of chest pain. Chest pain is a typical symptom related to problems in the heart or lungs, which are the most common locations for obstructions leading to shock.[8] Cardiovascular chest pain can sort of mimic heartburn or indigestion, but usually it's more severe and involves a feeling of fear or impending doom. Chest pain from a heart obstruction often involves referral pain to the left shoulder blade and down the left arm also.
    • Chest pain from a heart obstruction tends to be felt a little more on the left side of the upper chest, whereas as lung (pulmonary) obstruction is often felt more centrally or slightly to the right.
    • An obstruction in the lower aorta or vena cava often triggers pain lower in the stomach / intestinal area.
  6. 6
    Feel for a rapid heart beat. Although a person's pulse rate is weak (difficult to feel) with obstructive shock, their heart rate (number of beats per minute) is actually increased or elevated because their body is trying to overcome the shortage of blood around the body.[9] In essence, the heart beats faster, but not enough blood gets to peripheral arteries in the limbs to be easily detected.
    • A normal pulse rate for a healthy resting adult ranges from 60 to 100 beats per minute.[10] Levels above this indicate a problem with the heart.
    • Put your hand on the person's heart or close to it (such as the base of the neck) to see if it seems to be working harder than normal.
    • It's also not uncommon for an overworked heart to flutter or "skip a beat" with an obstruction.
  7. 7
    Be aware of little or no urine output. Another symptom of obstructive shock, and one that represents advanced organ failure, is little or no production of urine. As such, urinating is either very difficult or impossible because the kidneys no longer work well enough to filter water out of the blood, produce urine and send it to the bladder.[11]
  8. 8
    Consider the potential causes of obstructive shock. Obstructive shock occurs when there's a physical obstruction that prevents the heart from filling. However, you will probably not be able to determine the cause of the shock. This will be evaluated by medical personal at the hospital using diagnostic tests. Common causes of obstructive shock may include:[12] [13]
    • heart malformations or lesions
    • tension pneumothorax
    • cardiac tamponade
    • pulmonary thromboembolism
    • aortic dissection
    • vena cava syndrome

Part 2 of 2:
Managing Obstructive Shock with First Aid

  1. 1
    Call emergency services or get to a hospital immediately. Obstructive shock requires immediate medical attention because it's life-threatening. As such, if you notice any of the above-mentioned symptoms with yourself or with friends / family, call 9-1-1 for assistance immediately or transport the person to the emergency department of a hospital. Don't drive yourself if you feel any symptoms.
    • Call as soon as any of the signs and symptoms begin to develop — don't wait for them to get better or go away.
    • Stay with the person until medical assistance arrives and practice basic CPR while waiting.
  2. 2
    Check for circulation and breathing. While waiting for medical professionals to arrive, make sure the person is conscious and still able to breathe. As long as they are still conscious and their heart is still functioning, check the person’s rate of breathing every 5 minutes or so to see if it becomes more rapid.[14]
    • The more rapid and shallow the breathing, the more likely the person is about to have a heart attack and/or go unconscious.
    • Put your hand on their chest and keep your ear close to their mouth to monitor breathing and heart rate.
  3. 3
    Lay the person down. If the breathing becomes more labored and shallow, lay the person down so they don't injure themselves if they lose consciousness. Help them into the shock position (assuming there's no injury to the head, neck, spine or legs), by laying them down flatly with their feet elevated by about 12 inches, which will help improve circulation.[15] Loosen any tight clothing, especially around the neck.
    • Do not elevate their head because it makes it harder for the blood to get to their brain and may make symptoms worse.
    • If there's any vomiting or drooling, turn their head to the side to prevent them from choking.
    • Cover the person with a blanket or jacket to keep them warm, as shock causes the person to become hypothermic.
  4. 4
    Initiate rescue breathing and CPR if necessary. If the person loses their pulse and stops breathing altogether, initiate rescue breathing (mouth-to-mouth) and other CPR techniques if you are properly trained.[16] If you're not, then it's probably a better idea to just wait with the person until medical help arrives. Stay on the phone with 9-1-1 and they will advise you what to do. Although keep in mind that initial brain damage can occur in as little as five minutes once a person stops breathing and their heart stops beating.[17]
    • Thrusting over the person's heart helps circulate the blood somewhat, and in rare situations, it can "kick start" the heart into beating again.
    • Alternate chest thrusting with blowing air into the person's mouth. Make sure to elevate their chin (to open the airways) and pinch their nose so the air is forced down into the lungs.
    • Give two breaths, then 30 chest compression and then alternate between the two for as long as you can until help arrives.[18]
    • Compression only CPR is preferred for less trained rescuers.[19]

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      • Complications from obstructive shock include gangrene of the arms / legs, permanent brain damage and organ failure / damage and death.
      • CPR stands for cardiopulmonary resuscitation and can be lifesaving when someone's breathing or heart has stopped.

      About This Article

      Jonas DeMuro, MD
      Medically reviewed by:
      Board Certified Critical Care Surgeon
      1 votes - 100%
      Co-authors: 9
      Updated: May 25, 2021
      Views: 5,076

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