Which conditions can cause obstructive shock?

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Obstructive shock happens when a mechanical barrier prevents adequate blood flow or filling of the heart, so cardiac output falls even though the heart itself isn’t failing as a pump. Each of the listed conditions creates that kind of obstacle. In tension pneumothorax, air builds up under pressure in the chest and compresses the lungs and great vessels, raising intrathoracic pressure and dramatically reducing venous return to the heart. In cardiac tamponade, fluid accumulation around the heart compresses the chambers, especially during filling, so the ventricles don’t fill properly and stroke volume drops. In a massive pulmonary embolism, a large clot blocks the pulmonary arteries, increasing right-heart afterload and limiting blood flow to the lungs, which decreases left-sided filling and cardiac output. Because all three interrupt forward blood flow or filling, they can each cause obstructive shock.