A Case of Massive Hemothorax Leading to Obstructive Shock

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

¹Department of Internal Medicine, Beaumont Hospital, Dearborn, MI

²Division of Pulmonology and Intensive Care, Internal Medicine Department, Beaumont Hospital, Dearborn, MI

Cite this paper:
Hana Manzoor, Eman El-Sawalhy, Wehbi Hnayni, Gustavo Tataje Renfigo and Anthony G. Ashkar. A Case of Massive Hemothorax Leading to Obstructive Shock. American Journal of Medical Case Reports. 2021; 9(5):305-307. doi: 10.12691/ajmcr-9-5-12

Abstract

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.

Keywords:
obstructive shock massive hemothorax pleural effusion non-traumatic

This work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

References:

[1]	Standl T, Annecke T, Cascorbi I, Heller AR, Sabashnikov A, Teske W. The nomenclature, definition and distinction of types of shock. Deutsches Ärzteblatt International. 2018 Nov; 115(45): 757.
[2]	Habib R, Ahmed F, Khattak SK, Masoodi PW, Zaib Z, Riaz W. Massive pleural effusion: A rare cause of an obstructive shock. Isra Med. J. 2020; 12 (3): 166-167
[3]	Werlang ME, Pimentel MR, Diaz-Gomez JL. Thoracentesis-reverting cardiac tamponade physiology in a patient with myxedema coma and large pleural effusion. InBaylor University Medical Center Proceedings 2017 Jul 1 (Vol. 30, No. 3, pp. 295-297).
[4]	Mohammed M, Elhamdani S, Abusnina W, Majdi A, Yousef S. Inferior vena cava obstruction and shock. Journal of emergencies, trauma, and shock. 2018 Apr; 11(2): 146.