Shock Explained Clearly - Cardiogenic, Hypovolemic, and Septic

  • Published on Jul 16, 2012
  • Understand shock (cardiogenic, hypovolemic, and septic) and sepsis with clear illustrations from Dr. Seheult of .

    This is video 1 of 2 on shock (the types of shock and treatment).
    Includes a discussion of cardiogenic shock, hypovolemic shock, and septic shock (neurogenic shock will be in a future medical lecture).

    Speaker: Roger Seheult, MD
    Clinical and Exam Preparation Instructor
    Board Certified in Internal Medicine, Pulmonary Disease, Critical Care, and Sleep Medicine.

    MedCram: Medical topics explained clearly including: Asthma, COPD, Acute Renal Failure, Mechanical Ventilation, Oxygen Hemoglobin Dissociation Curve, Hypertension, Shock, Diabetic Ketoacidosis (DKA), Medical Acid Base, VQ Mismatch, Hyponatremia, Liver Function Tests, Pulmonary Function Tests (PFTs), Adrenal Gland, Pneumonia Treatment, and many others. New topics are often added weekly- please subscribe to help support MedCram and become notified when new videos have been uploaded.


    Recommended Audience: Health care professionals and medical students: including physicians, nurse practitioners, physician assistants, nurses, respiratory therapists, EMT and paramedics, and many others. Review for USMLE, MCAT, PANCE, NCLEX, NAPLEX, NDBE, RN, RT, MD, DO, PA, NP school and board examinations.

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    Produced by Kyle Allred PA-C

    Please note: MedCram medical videos, medical lectures, medical illustrations, and medical animations are for medical education and exam preparation purposes, and not intended to replace recommendations by your health care provider.

Comments • 313

  • Darrin Capps
    Darrin Capps 5 years ago +55

    I am a nursing student in my final semester and your MedCram videos have been incredibly helpful. They provide that added background information that may not be available during lecture to answer the "why" questions. Thank you and keep up the great work!

    • William Sanderson
      William Sanderson 2 years ago +3

      @youre a star Why you salty tho hypernatremia bruh

    • Last Name Left
      Last Name Left 5 years ago +4

      Yeah, reading the textbook doesn't help me very much; that just isn't my learning style. These videos are fantastic.

    • Robert Ritchie
      Robert Ritchie 5 years ago +14

      not everyone has the same learning style, I learn a lot more from watching videos that I do from reading my books

    • youre a star
      youre a star 5 years ago +2

      reading the textbook helps too.

  • Angelo Aguas
    Angelo Aguas 5 years ago +8

    You lectures are amazingly clear and very systematic. As a nursing instructor, It gives more understanding. Thanks for all your efforts.

  • Sapphire
    Sapphire 6 years ago +12

    This was superbly informative, both interesting and easy to understand. Thank you for the effort and consideration, i learnt a lot!

  • TheSingingRN
    TheSingingRN 3 years ago +2

    Your clear and concise explanation was great!!! I’m an oncology nurse trying to get into the ICU and needing to brush up on some in depth shock knowledge. Thanks!

  • Sterling Archer
    Sterling Archer 5 years ago +5

    Thank you so much. I am an EMT working to become a paramedic. Your videos are easy to understand and very useful in both an academic and practical sense. Keep up the great work. You are an excellent educator.

  • Alfred Hughes
    Alfred Hughes 8 years ago +1

    Thank you so much for these lectures! I had no idea what was going on with respect to shock in my EMT class! I really hope you consider making more videos that can help EMT's and future EMT's such as myself!

  • Reychill 91
    Reychill 91 8 years ago +3

    Hi Doctor, I love all your topics very much. They are all explained clearly. can I ask for your help to do on other lecture topics? If its possible, I hope you can explain also topics such as ECG, acute coronary syndrome, myocardial infarction, pneumonia, TB, hepatitis, neoplasm, gastritis and ulcer, intestinal obstruction and inflammatory bowel disease. Hope this long lists wouldn't be too demanding. its okay if you wouldnt like to cover all. but I really hope you can choose from some of it.

  • Pao
    Pao 6 years ago

    Love this lecture on shock, really helps for my pathophysiology class, thanks!

  • Yasmin E
    Yasmin E Year ago +1

    Can you cover anaphylactic shock? This video is great, helped me understand the concepts of shock so much better, especially septic shock, which occurs on a regular basis in my patient population at work.

  • cyndy loguercio
    cyndy loguercio 6 years ago +1

    this was the most helpful video I have seen yet! thank you for your wonderful teaching methods! I have subscribed to your videos in hopes of lots more like this! Big test coming up tomorrow, this has helped me a lot!

  • Liz K
    Liz K 6 years ago

    Hi Dr. Seheult. Thank you for your clear easy-to-understand lectures (listening to them since my graduating year in RN in 2012). Can you explain how ejection fraction is decreased in septic shock?

  • Martin Lee
    Martin Lee 9 years ago

    Dr. Seheult, thank you for taking time out of your I assume, pretty hectic schedule to make these lectures for medical students around the world. As a paramedic intern that is about to take the national registry exam, this was a great (under statement) review. Keep up the great work! Thank you

  • brudforce
    brudforce 4 years ago

    Dear Dr. Seheult,

    Thank you for the wonderful video, it is very helpful and much appreciated.

    I would just like to confirm that the reason for a decrease in EF for septic shock is due to increased HR that leads to increased CO which therefore decreases filling time that results in decreased SV. Hence given the equation EF= SV/EDV, it goes down.

    Warmest Regards,

  • Brittany Payne
    Brittany Payne 8 years ago

    This was a great lecture!!! Thank you for the simple explanation. The graph has helped me greatly

  • K K
    K K 4 years ago +2

    Oh my gosh --- this was the missing piece in my brain. Thank you for bringing this topic altogether! I look forward to the next video on treatment of the different shocks. :)

  • Wali Chowdhury
    Wali Chowdhury 4 years ago +1

    This was always a difficult topic for me to understand. I used get these questions wrong when doing q banks. Thank you so much!

  • Katelyn Bach
    Katelyn Bach 8 years ago

    Your lectures are great! I love that they are directed towards visual learners (which I am), and that you hit such important topics. I always use these to supplement all of my notes in my nursing school classes

  • ZBridgeridoo
    ZBridgeridoo 8 years ago

    Hi Rodger, great videos! This video is good but I think it may be worth your time to break down each form of shock because as you know, there are various stages to each form of shock with altered hemodynamics. Thanks again!

  • Saria Naser
    Saria Naser 2 years ago

    Awesome explanation! Cleared my concepts! Thanks a lot sir!

  • Henry Gavilanez
    Henry Gavilanez 7 years ago

    You made it so easy to understand. This finally makes sense. Thanks

  • Katy Juthman
    Katy Juthman 8 years ago +1

    Thank you! Your videos help me learn what is being taught in pathophysiology!

  • Kathleen Ferron
    Kathleen Ferron 8 years ago

    Excellent Lectures! Thank You, wonderful tool to use while I study for my CCRN.

  • Woutube Yatcher
    Woutube Yatcher 2 years ago +1

    I'm an audio-visual learner and there's no way I will understand all these things without looking at your diagram and chart. Thank you for uploading this videos. They help a lot.

  • Andrew Blair
    Andrew Blair 6 years ago

    Very informative and easy to understand. Can you please do a presentation over ARDS or burn patients?

  • James Solomon
    James Solomon 8 years ago

    Very informative! We are using this in my nursing class to reinforce our lecture. Great video! Thanks! :0)

  • MsCbear87
    MsCbear87 9 years ago

    Absolutely love your diagrams (and hand writing)--your videos have been very helpful. This will help with my transition to ICU as an RN

  • David Austin
    David Austin 3 years ago +4

    Summary: Hypovolemic - not enough blood to go around so heart works hard, so LA and RA go up. Cardiogenic - heart becomes too weak (example, from hypovolemia) to pump blood, so LA and RA go down. Septic - the endothelium (the on/off ramps of the arteries & veins) is too sick to properly pass blood components so they dilate, so LA and RA go down, but skin temp goes high. (LA=Left Atrium pressure, RA = Right Atrium pressure).

  • Yanky Doodle
    Yanky Doodle 7 years ago +3

    Thank you for such a clear explanation and outline. You are a great teacher.

    • Theivv IBP
      Theivv IBP 6 years ago

      Your work here is greatly appreciated. I really enjoy seeing how physicians work through pathophysiology, and they do not always have time to explain to the nursing staff due to patient loads. Thank you for positively impacting my practice!

    • MedCram - Medical Lectures Explained CLEARLY
      MedCram - Medical Lectures Explained CLEARLY  7 years ago +1

      @Yanky Doodle Thanks for the feedback

  • Amanda Grant
    Amanda Grant 9 years ago

    I am an RN student. I really enjoyed this video and found it to be incredibly helpful. Thanks! liked and subscribed!

  • le cuong
    le cuong 5 years ago +1

    You make it simple. I love your lecture. Thanks you so much.

  • Linda Sa
    Linda Sa 5 years ago +2

    clearly explained.... and at the same time very easy to follow... thank you very much you helped me a lot ... :)))

  • Didas M. Gisagara
    Didas M. Gisagara 4 years ago

    Thanks for this video. Wonderfully explained. You didn't talk about Anaphylactic and Neurogenic shock though.

  • Jennette Pearson
    Jennette Pearson 7 years ago +2

    This was very informative, do you have anything on acid/base balance?

  • Mary D
    Mary D 8 years ago

    Loved your video on the different types of shock. I particularly like the way you break down the types in a way that is easy to follow and comprehend.

  • Lisa Bowling
    Lisa Bowling 8 years ago

    Fantastic! Easy to follow along with your explanations... Keep them coming!

  • Linda Tran
    Linda Tran 8 years ago

    Quick and easy to understand for nursing . Thank you!

  • Zahraa Al-Adily
    Zahraa Al-Adily 6 years ago +16

    Love it
    so simple and clear :)
    I will remember it for ever :D
    God bless you and looking forward for more videos

    FANNY BASUA 2 years ago +1

    Thank you so much. I am a 2yr nursing student. You don't know how helpful this video is to me.

  • Innocent Flippen
    Innocent Flippen 8 years ago

    This is a great and clear explanation. I have a question from a paramedic student point of view. You list the major indices for distinguishing between the different types of shock as the PCWP and the JVP; how would a paramedic in the field distinguish between cardiogenic and hypovolemic shock? Thanks!

  • Lauren Bradshaw Cumella
    Lauren Bradshaw Cumella 7 years ago +2

    Thanks for all your videos! How about something on neurogenic shock too?

  • Liza Jardiolin
    Liza Jardiolin 8 years ago

    thank you for posting your informative and easy to understand videos!

  • Joseph Landas
    Joseph Landas 8 years ago

    Great videos and very helpful! Thank you!

  • Tomasz Olbrycht
    Tomasz Olbrycht 8 years ago

    Your lectures are amazing.
    I'm a medical student from Poland, and all Your videos are extremely helpful.
    Thank You!!!!

  • ekiru kidalio
    ekiru kidalio Year ago

    Thank you for clarity of thought and content Dr. Rodgers

  • Who Dey
    Who Dey 5 years ago +1

    very easy to understand! Thank you.

  • Deven Sanchaniya
    Deven Sanchaniya 8 years ago

    very well explained,,,
    I looking forward to see your other topics as well...
    Such kind of clean explaination can save your much time from jumping into books....
    Thanks a lot

  • MedicEne
    MedicEne 5 years ago

    Thank you so much for this, I have no idea how people can dislike this, it was perfect

  • Merrin27
    Merrin27 8 years ago

    Thank you, it helped me to understand the concept in a short time. please continue your effort.

  • H Arian
    H Arian 2 years ago +1

    thanks, your various lecture were incredibly helpful.

  • David Gammell
    David Gammell 8 years ago

    Thank you for your videos. I use them when I teach EMTs and First Responders so they don't have to listen to me all night. They appreciate your work!!!

  • karleenkyle1
    karleenkyle1 8 years ago

    Simplest explanation I've heard. Thank you!!!!

  • Saud MD
    Saud MD 5 years ago

    How the EF can be low WITH CO high (initially) ??

    By the way , thank you so much . I love the way that you explain by (giving everything reasonable in every topic)
    Thanks , keep it going :)

    • Saud MD
      Saud MD 5 years ago

      Although CO is maintained or elevated during septic shock, intrinsic cardiac dysfunction is demonstrable in up to 40% of patients, and while the stroke volume is maintained, due to alterations in the peripheral circulation and possibly ventricular dilatation, LVEF is often depressed. The mechanisms underlying this myocardial depression have not been fully elucidated and there are still many unanswered questions

      british journal of anaesthesia (BJA)

  • Kendra French
    Kendra French 8 years ago

    Loved this....watched it twice and copied the chart. Very helpful!

  • Timo Ba Ta Na
    Timo Ba Ta Na Year ago

    This is incredible. Simply awesome video thank you for posting

  • Luna M
    Luna M 3 years ago +1

    Thanks for the clear explanation! Great video

  • s evans
    s evans 9 years ago

    Thank you! so helpful for my RN studies!

  • Matthew Martin
    Matthew Martin 2 years ago

    My friend had septicemia and ended up with septic shock from a botched back surgery. The surgeon left an open wound to his spine which caused a streptococcus infection in his blood stream. It took 4 days for acute renal failure and a x2 code. He survived.

  • Fatihah Saidin
    Fatihah Saidin 5 years ago +1

    great explanation, i liked it so much ! thanks!

  • simplydee2011
    simplydee2011 9 years ago

    Very nicely done! Thanks!

  • Gwyneth Le
    Gwyneth Le 8 years ago

    beautifully explained! thank you so much

  • Durai vengatesan
    Durai vengatesan 5 years ago

    All your videos are awesome doc.I'm your biggest fan.I suggest all my friends to watch your videos.You are doing a great job.Thank you doc.

  • jefferson emiliano
    jefferson emiliano 5 years ago +1

    Very nice job, helped me a lot. Thank you, it is very nice to have somebody dedicate to share.

  • Darren Peck
    Darren Peck 6 years ago +1

    Please cover chest x-rays, and head injury! Thank you for the lectures. Are you going to publish a book?

  • L V
    L V 8 years ago

    thank you very much for the explanation..Im a visual learner and these videos helped me a lot

    ARPAN KUMAR 5 years ago +1

    explained really precisely :-)

  • Francisco Duenas
    Francisco Duenas 6 years ago

    Excellent video, but could you please explain why does the ejection fraction goes down on the septic shock??

  • Jordan Harmor
    Jordan Harmor 8 years ago

    Incredible! Thank you so much :)

    HYE CHO 2 years ago +5

    Always appreciative of Dr . Seheult's brilliant lectures

  • Jessica Tente
    Jessica Tente 8 years ago

    Great lecture. Thanks a lot.

  • Florencia Wijanarko
    Florencia Wijanarko 5 years ago

    pardon Doc, do you have a learning of normal and pathological breath sound?thankyou for this video. love it because I can describe those when my lecturer asked me. :)

  • eman mahmoud
    eman mahmoud 6 years ago

    Excellent and very simple explains many thanks for you

  • Japhet Jibril
    Japhet Jibril 2 years ago +1

    this is great, loving it. In septic shock due to an infection causing a release of histamines, leukotrienes, cytokines, and other bad stuff inside the blood vessels. The blood vessels dilate and become inflamed, leaky, and permeable to water causing a decrease in blood pressure.

    could you please run us through the stages of shock @medcram

    • Ash Ley
      Ash Ley 2 years ago

      Japhet Jibril check out the simple nursing channel. He has a video on it and stages it’s really detailed.

  • Ashley Smith
    Ashley Smith 8 years ago

    Thank you so much, I wish I would have watched this the first time I took critical care.

  • Jamie Sculley
    Jamie Sculley 5 years ago +1

    easy to understand! thanks!

  • esteban Justo
    esteban Justo 9 years ago

    would you consider doing a lecture specifically on Systemic inflammatory response syndrome (SIRS) ? thank you so much for your work!

  • Kyle Murphy
    Kyle Murphy 3 years ago +9

    My girlfriend is Filipino and she is in nursing, I’m just the average white guy but I tried to take interest in her nursing, and I have come to study and learn much as I can.

  • Sonny White
    Sonny White 8 years ago +2

    Very Good...the best explanation I've ever seen.

  • Superfluffy
    Superfluffy 8 years ago

    Thank you so much, this was very helpful in preparing for my state exam

  • Isabelle Joseph
    Isabelle Joseph 6 years ago

    excellent, thank you. keep the lectures rolling.

  • eternalfizzer
    eternalfizzer Year ago

    Thank you for giving me the back story on shock - that's far beyond my AMFR training!

  • Eric Goldstein
    Eric Goldstein Year ago

    Great video. I don’t understand why EF would be high if CO is low. I understand that contractility and HR would increase to compensate, but as preload decreases, would expect that EF would also decrease?

  • Angel C.
    Angel C. 6 years ago +1

    Thanks for these explanations!

  • Rashawna Hughes
    Rashawna Hughes 9 years ago

    very easy to an RN student who learn a lot from your videos! thanks!!

  • lksdgvuwni
    lksdgvuwni 9 years ago

    Could you please add some information on hypovolemic shock? Specifically:
    - mechnaisms of centralization of a circulation
    - pathological deposition of a blood
    - development of a toxemia
    - what is going on in microcirculation
    What is "shock kidney", "shock lung", and "shock liver"?
    Thank you

  • Lauren D
    Lauren D Year ago +1

    This just helped me SO MUCH!!!! THANK YOU!!!!

  • Ahmad El-Tahan
    Ahmad El-Tahan Year ago +1

    This was so well put !

  • Nepalidoctorskitchen
    Nepalidoctorskitchen 5 years ago +2

    How come the ejection fraction increases when the cardiac output is decreased ? Could you please elaborate?

    • dfailsthemost
      dfailsthemost 5 years ago

      increased HR. Lower pressure but higher output

    • Courtney Peters
      Courtney Peters 5 years ago +1

      I believe it's to compensate for the decreased CO. The left ventricle of the heart will work harder (increase contractility) in an effort to increase CO, which increases the EF.

  • Natasha Lee
    Natasha Lee 6 years ago

    Yes this explanation was extremely clear. I thought I understood before but now I really understand. THANKS!!!! Getting NCLEX ready

  • Walking by faith
    Walking by faith 7 years ago

    Great post helped me pass my exam on shock and hematologic disorders ... thanks

  • Chaosian01
    Chaosian01 8 years ago

    I'm just a second year university computers student that writes in his spare time, and even I found this video clear, concise, and 85% of which was quite easy to understand. Thanks for the video!

  • Nick - Comic Culture
    Nick - Comic Culture 8 years ago

    another great video! keep them coming!!

  • Elsie Honey
    Elsie Honey 5 years ago

    I have such a better understanding of this subject now!!! Take the time to watch this video and take the time to write it out independently and you will be so great about yourself!

  • Fikret Nakip
    Fikret Nakip 5 years ago

    Wonderful explanation of shock thanks

  • Rrr Zz
    Rrr Zz 4 years ago

    This really is a great addition to learning, thank you. Is it possible to - like - do we have to watch you 'draw' - would it be
    better if the analogies just 'popped' into the screen?

  • Sarah Chicatto
    Sarah Chicatto 4 years ago +1

    Best explanation ever!

  • MrA91000
    MrA91000 8 years ago

    Great video, but I have a question. In hypovolemic shock, how is possible the Cardiac Output to be decreased and the Ejection Fraction increased? Since, CO is the volume of blood being pumped by the heart in the time interval of one minute and EF is the volume of ejected blood by the heart in one cardiac cycle (heart beat).

  • Lisa Hunt
    Lisa Hunt 7 years ago

    Good lecture. Have been suggesting my nursing school have a separate workshop on shock. In clinical practice, wondering how often we would have immediate access to JVP and PCWP measures as those are key features of the differences between. IS there time when shock sx appear to get those pressures? From my readings, other key features, easily readable, early visible signs of any shock would be rapid respirations, thready pulse. Tachy, tachy, hypo. Yes? I'll look at the EGDT to see if its the same for all three.

  • Hemi Grl
    Hemi Grl 2 years ago +1

    This was awesome. Thank you!

  • Raberle
    Raberle 9 years ago

    excellent series, would like to see liver failure / hepatic encephalopathy. Also including drugs to Tx if this is within your scope

  • Capt. Spauldings Secret Service

    Great information !! Thanks for the videos