Pericardial tamponade shock

Occurs as a result of circulatory insufficiency associated with overwhelming infection Occurs when obstruction of blood flow results in inadequate tissue perfusion. Examples include a severe reduction of blood flow as the result of massive pulmonary embolism, pericardial tamponade, restrictive pericarditis, and severe cardiac valve dysfunction Occurs as a result of blockade of neurohum oral outflow. Examples include from a pharmacological source (ie, spinal anesthesia) or direct injury to the spinal cord. This type of shock is rare. 

The more serious events include massive hemorrhage with shock, intracranial bleeding and stroke, and pericardial tamponade. Plasma warfarin levels are not routinely done. The effect of warfarin is best followed by the PT and International Normalized Ratio (INR). Under therapeutic conditions the INR is maintained at 2.0-3.0, except for prophylaxis after artificial heart valve replacement when it may be 2.0-3.5. Specific assays of factor activity can be measured although this is not usually necessary. 

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