In this type of shock, right atrial pressure is typically low:

In distributive shock, the primary issue is widespread vasodilation resulting from the loss of vascular tone, which can occur in conditions such as septic shock or neurogenic shock. This vasodilation leads to pooling of blood in the peripheries, which results in decreased venous return to the heart. Consequently, this reduced venous return translates to a lower right atrial pressure, as there is less blood volume effectively returning to the heart.

In contrast, cardiogenic shock typically involves impaired pumping function of the heart, often leading to increased right atrial pressures due to volume overload. Hypovolemic shock results from significant blood loss or fluid loss, which can cause a drop in right atrial pressure, but not to the same extent as seen in distributive shock where the effects of vasodilation are more pronounced. Obstructive shock is characterized by physical obstruction to blood flow, such as in the case of cardiac tamponade or pulmonary embolism, and can also elevate right atrial pressures due to impaired filling of the heart.

Thus, in the context of distributive shock, the low right atrial pressure reflects the underlying pathophysiology of decreased venous return attributable to significant peripheral vasodilation.