What are the early clinical manifestations of shock?

The occurrence of shock needs to be taken seriously, because once shock occurs and no timely treatment measures are taken, it will directly threaten life. The early symptoms include pain, and sometimes fever, tachycardia or arrhythmia.

1. Pain is the first symptom to appear. The location and nature of the pain are the same as those of angina pectoris. There is usually no obvious cause. It often occurs at rest and is severe and lasts for a long time, up to several hours or days. Rest and taking nitroglycerin tablets often cannot relieve the pain. Patients often feel restless, sweaty, fearful, or have a sense of impending death. A small number of patients have no pain and show symptoms of shock or acute heart failure at the beginning. Some patients have pain in the upper abdomen, which is mistaken for acute abdominal diseases such as gastric perforation and acute pancreatitis. Some patients have pain radiating to the neck and upper back, which is mistaken for bone and joint pain.

2. Systemic symptoms include fever, tachycardia, increased white blood cell count and increased erythrocyte sedimentation rate. The body temperature is generally around 38 degrees, rarely exceeding 39 degrees, and lasts for about a week.

3. Gastrointestinal symptoms: Severe pain is often accompanied by frequent nausea, vomiting and upper abdominal distension and pain. In severe cases, hiccups may occur.

4. Arrhythmia occurs in 75% to 95% of patients, mostly within 1 to 2 weeks of onset, and most commonly within the first 24 hours, and may be accompanied by symptoms such as fatigue, dizziness, and fainting.

5. Hypotension and shock: A drop in blood pressure is common during the pain period, but it does not necessarily lead to shock. If the pain is relieved but the systolic blood pressure is still lower than 10.67kpa (8mmHg), and the patient is irritable, pale, has cold and clammy skin, a thin and rapid pulse, sweating, decreased urine volume (<20ml per hour), is dulled, or even faints, then these are signs of shock. Shock usually occurs within a few hours to a week after onset.

6. Heart failure is mainly acute left ventricular failure.