◦Weak, cold, hot, nauseated, dizzy, confused, afraid, thirsty, short of breath, and generally "feeling sick"
◦Decreased blood pressure, cardiac output, and urinary output
◦Increased respiratory rate
◦Inability of the heart to pump adequate blood to tissues and end organs from any cause
◦Causes: Myocardial ischemia, myocardial infarction (MI)
◦Persistent hypotension and tissue hypoperfusion caused by cardiac dysfunction in the presence of adequate intravascular volume and left ventricular filling pressure
◦Decrease in cardiac output
◦As cardiac output decreases, compensatory adaptive responses are activated: Renin-angiotensin, neurohormonal, and sympathetic nervous system
Compensatory responses: Fluid retention, systemic vasoconstriction, and tachycardia.
Catecholamines increase contractility and heart rate.
◦Activates inflammatory response
◦Increased myocardial requirements burden the already failing heart.
-The heart can no longer pump an adequate volume of blood with sufficient force to perfuse the tissues.
Chest pain, dyspnea, and faintness, along with feelings of impending doom
Classic hallmarks: Tachycardia, tachypnea, hypotension, jugular venous distention, dysrhythmia, and low measured cardiac output
◦Infectious processes initiate septic shock.
◦Six most common infection sites are the lungs, bloodstream, intravascular catheter, intra-abdominal, urinary tract, and a surgical wound.
◦Bacteremia, endotoxins, and exotoxins cause the host to initiate the inflammatory process.
Activates the complement, coagulation, and kinin systems and cellular immunity.
Initiates and promotes widespread vasodilation.
Persistent low arterial pressure, low SVR from vasodilation, and an alteration in oxygen extraction by all cells.