Shock: Or something else? Differential Diagnosis

Respiratory System (J00-J99)

  • Pulmonary hemorrhage, unspecified
  • Tension pneumothorax – life-threatening condition characterized by collapse of the lung with development of excess pressure.

Certain conditions originating in the perinatal period (P00-P96).

  • Liver rupture as a birth injury
  • Splenic rupture as birth injury

Blood, blood-forming organs – immune system (D50-D90).

  • Splenic rupture (rupture of the spleen)

Skin and subcutaneous tissue (L00-L99)

  • Generalized dermatitis – acute skin reaction, unspecified.

Cardiovascular system (I00-I99)

  • Acute left heart failure (LHV).
  • Acute right heart failure (RHV)
  • Aneurysm dissecans – cleavage of the arterial wall.
  • Embolism/thrombosis of the vena cavaocclusion of the vena cava by an embolus/thrombus.
  • Decompensated cardiac ventricles (valvular defects).
  • Cardiac arrhythmias such as ventricular tachycardia (ventricular tachycardia).
  • Cardiomyopathy – group of heart muscle diseases that leads to a reduction in cardiac function.
  • Pulmonary embolismocclusion of a pulmonary vessel.
  • Myocardial infarction (heart attack) – about 90% of patients survive a myocardial infarction; if cardiogenic shock occurs initially or in the course of a myocardial infarction, then the survival rate of infarction-related cardiogenic shock (ICS) patients is only about 50%, because of the formation of a multiorgandysfunction syndrome (MODS)/simultaneous or sequential failure or severe functional impairment of various vital organ systems of the body.
  • Myocarditis (inflammation of the heart muscle).
  • Papillary muscle rupture – acute life-threatening condition that leads to limitation of heart valve function.
  • Pericardial tamponade – tamponade of the pericardial sac resulting in cardiac compression.
  • Rupture (tear) of an aortic aneurysm – outpouching in the vessel wall.
  • Traumatic rupture of a heart valve
  • Ventricular septal rupture – defect in the ventricular septum.

Infectious and parasitic diseases (A00-B99).

  • Sepsis (blood poisoning)
  • Toxic shock syndromes (toxic shock syndrome, TSS; synonym: tampon disease) – severe circulatory and organ failure caused by bacterial toxins (usually enterotoxin of the bacterium Staphylococcus aureus, less commonly streptococcus, then called streptococcal-induced toxic shock syndrome).

Liver, gallbladder, and bile ducts-pancreas (pancreas) (K70-K77; K80-K87).

  • Liver rupture (liver tear)
  • Pancreatitis (inflammation of the pancreas)

Mouth, esophagus (esophagus), stomach, and intestines (K00-K67; K90-K93).

  • Gastrointestinal diseases with acute bleeding such as ventriculi ulcer (gastric ulcer).
  • Hematoperitoneum – accumulation of blood in the abdominal cavity.
  • Ileus (intestinal obstruction)
  • Peritonitis (inflammation of the peritoneum)

Neoplasms (C00-D48)

  • Pheochromocytoma – catecholamine-producing tumor of the chromaffin cells of the adrenal medulla (85% of cases) or sympathetic ganglia (nerve cord that runs along the spine in the thoracic (chest) and abdominal (stomach) regions) (15% of cases). The latter is also called extraadrenal (outside the adrenal gland) pheochromocytoma or paraganglioma

Symptoms and abnormal clinical and laboratory findings not classified elsewhere (R00-R99).

  • Ascites (abdominal dropsy)
  • Hypovolemic shock – shock due to acute volume deficiency.
  • Cardiogenic shock – shock due to acute pump failure (acute right heart failure (RHV), acute left heart failure (LHV).
  • Neurogenic shock – shock due to irritation of the autonomic nervous system as a result of painful injury.
  • Polyuria – amount of urine > 2l/day.
  • Septic shock – shock due to severe generalized infection resulting in disruption of peripheral circulatory regulation with relative volume deficiency due to vascular dilatation.
  • Excessive sweating
  • Volume deficiency due to vomiting, diarrhea (diarrhea), hormonal dysfunction.

Genitourinary system (kidneys, urinary tract – sex organs) (N00-N99).

  • Renal rupture (kidney rupture)

Injuries, poisoning, and other consequences of external causes (S00-T98).

  • Allergic reaction, unspecified (e.g.B. bee or wasp sting; insect stings are the most common triggers of severe anaphylaxis in adulthood and the second most common in childhood).
  • Anaphylactic shock due to food allergy (most common trigger of severe anaphylaxis in childhood)
    • In young children: Peanuts, cow’s milk, and chicken egg white.
    • In children: Peanuts, cow’s milk and chicken protein.
    • In adults: Wheat and shellfish
  • Anaphylactic shock, unspecified.
  • Bleeding into large body cavities/soft tissues as a result of trauma
  • Blood loss due to injuries
  • Drainage of large effusions
  • Fat embolismocclusion of vessels by penetration of fat droplets from the tissue.
  • Fractures (bone fractures)
  • Air embolism – occlusion of vessels by penetration of gas bubbles into the bloodstream.
  • Splenic rupture (rupture of the spleen)
  • Postoperative bleeding complications
  • Burns

Differential diagnoses for anaphylaxis see below “Anaphylaxis”.

Differential diagnoses for cardiogenic shock see below “Cardiogenic shock”