Hana Manzoor^1,, Eman El-Sawalhy¹, Wehbi Hnayni¹, Gustavo Tataje Renfigo¹, Anthony G. Ashkar²

Obstructive shock is one of the rarest types of shock. It is caused by the reduction of cardiac output despite normal intravascular volume or cardiac function. In this case report, we present a case of a seventy-four-year-old female, who was sent to our emergency department (ED) for evaluation of one week history of dyspnea and abnormal chest X-ray. Initial Contrast Tomography (CT) scan of the chest showed a large necrotic left upper lobe mass with multiple pulmonary nodules, small left-sided pleural effusion and mediastinal lymphadenopathy. Few days later, she developed worsening dyspnea and hypotension, requiring intubation and vasopressors for hemodynamic support. A repeat CT scan showed large left-sided pleural effusion with rightward mediastinal shift that required thoracostomy tube insertion to immediately improve the underlying obstructive shock.

obstructive shock, massive hemothorax, pleural effusion, non-traumatic