What causes obstructive shock? Causes of obstructive shock include: Tension pneumothorax (collapsed lung). Vena cava compression syndrome (a large blood vessel that gets compressed). Pulmonary (lung) compression syndrome. High-PEEP (positive end-expiratory pressure) ventilation (pressure in your airways after the ventilator exhales). Tumors. Thromboembolism (clot) in the pulmonary artery. Pericardial tamponade (excess fluid around your heart compresses it). Aortic dissection (a rip in your aorta). Aortic stenosis (the opening to your aortic valve gets narrow). Hypertrophic cardiomyopathy (thickened heart muscle causes obstruction of flow out of your heart). Constrictive pericarditis (the sac around your heart gets thick).