Hypotension: Causes & Reasons

Possible Causes for Hypotension

Orthostatic hypotension is otherwise known as postural hypotension, since a change of posture is responsible for the sudden-onset episode of decreased blood pressure. [symptoma.com]

Orthostatic hypotension may be acute or chronic. [aafp.org]

Algorithm for the evaluation of suspected orthostatic hypotension in the acute care setting. Orthostatic Hypotension Evaluation: Acute Care Setting Figure 2. [aafp.org]

Vasovagal Syncope

Table 5: Abnormal Hemodynamic Patterns During Tilt Test Vasovagal response Cardioinhibitory response, hypotension and bradycardia or asystole Vasodepressor response, hypotension [clevelandclinicmeded.com]

POTS has recently been conflated with VVS when excessive tachycardia is succeeded by hypotension during tilt testing. [ncbi.nlm.nih.gov]

The body's overreaction to a given trigger causes a sudden drop in both heart rate and blood pressure (hypotension). [cumming.ucalgary.ca]

Acute Kidney Injury

[…] by hypotension was similar in the two groups. [ncbi.nlm.nih.gov]

and 0 point for not having hypotension; 0 point for ATN-ISI score Table 5 Prognostic score of 90-day mortality in hospitalized patients with acute kidney injury. [doi.org]

Our results showed that Patient's age, AKI types, respiratory failure, central nervous system failure, hypotension, and acute tubular necrosis-individual severity index (ATN-ISI [ncbi.nlm.nih.gov]

Sepsis

[…] of severe hypotension. [en.wikipedia.org]

Administration of 30 ml/kg IV crystalloid for hypotension or lactate ≥ 4 mmol/L. [cdemcurriculum.com]

The cardinal symptoms of sepsis include: Fever, chills or hypothermia Hypotension and oliguria Hyperventilation Mental status changes Skin manifestations These features may [symptoma.com]

Syncope

The modifying influence of prolonged antihypertensive treatment on the tolerance to acute, drug-induced hypotension. Circulation 1976;53:720–727. [innovationsincrm.com]

"Orthostatic Hypotension". [en.wikipedia.org]

Diabetic Autonomic Neuropathy

Abstract Postural hypotension is uncommon in diabetes but can occur secondary to autonomic neuropathy. [ncbi.nlm.nih.gov]

Abstract Postural hypotension results from sympathetic failure to cause superior peripheral vasoconstriction. [ncbi.nlm.nih.gov]

[…] pressor effects while standing in patients with orthostatic hypotension, 3 but they have not been widely used in hypotensive patients because it has also been reported that [nature.com]

Hypovolemia

Although hypovolemia may intuitively seem a likely cause for hypotension in intensive care patients, its role in the pathogenesis of intradialytic hypotension may be overestimated [ncbi.nlm.nih.gov]

KEYWORDS: Blood donation; Blood pressure variability; Heart rate; Heart rate variability; Non-hypotensive hypovolemia [ncbi.nlm.nih.gov]

Dr Chris O'Donnell ◉ Diagnosis certain Diagnosis certain Presentation MVA with signs of marked blood loss Patient Data Age: 25 Gender: Male From the case: Hypovolemia and hypotension [radiopaedia.org]

Autonomic Neuropathy

We present a unique case of orthostatic hypotension as the sole feature of a CRMP-5 paraneoplastic autonomic neuropathy in a patient with small cell lung cancer. [ncbi.nlm.nih.gov]

The bladder problems tend to improve earlier than orthostatic hypotension. [ncbi.nlm.nih.gov]

CAN was assessed by 5 CARTs: the deep breathing test, Valsalva ratio, 30/15 ratio, handgrip and orthostatic hypotension test. [ncbi.nlm.nih.gov]

Hypotension

See More First Known Use of hypotension 1893, in the meaning defined above Learn More about hypotension Resources for hypotension Statistics for hypotension More Definitions [merriam-webster.com]

NOS, Hypotension, unspecified, Hypotension, Vascular, Vascular Hypotension, Low Blood Pressure, hypotension (diagnosis), hypotension, hypotension (physical finding), hypotension [fpnotebook.com]

[…] low pressure of the intraocular fluid Comments on hypotension What made you want to look up hypotension ? [merriam-webster.com]

Low-Cardiac-Output Syndrome

Etiology Syndrome ass. with CV instability and hypotension. • Sepsis ( Hypotension with ed SVR) • Anaphylactic reaction (blood products, drugs) • Adrenal insufficiency (primary [de.slideshare.net]

[…] supraventricular arrhythmias, development of LCOS, acute kidney injury (AKI), duration of mechanical ventilation, intensive care unit and hospital lengths of stay, and incidence of hypotension [ncbi.nlm.nih.gov]

Management ---------- If refractory hypotension – vasoplegia MAP< 50, Low filling pressures – CVP < 5, PCWP<10 Normal or elevated CI >2.5L/min/m2 Low SVR < 800 Vasopressor [slideshare.net]

Acute Coronary Syndrome

Patients present with hypotension and distended neck veins, but without signs of pulmonary odema. [rcemlearning.co.uk]

S3/S4, APO, edema, distended tender liver) Look for any evidence of cardiogenic shock (altered mental state, poor skin perfusion +/- hypotension) Clinical Risk Stratification [litfl.com]

This can be due to acute thrombosis and plaque rupture, or to increased supply and demand from comorbid disease presentations (e.g., tachycardia, hypotension or anemia). [ncbi.nlm.nih.gov]

Pulmonary Embolism

During admission, the patient developed sudden, severe hypotension that was refractory to treatment. [ncbi.nlm.nih.gov]

Ultimately, insufficient cardiac output from the RV causes left ventricular under-filling which results in systemic hypotension and cardiovascular collapse. [ncbi.nlm.nih.gov]

This case report describes a patient with intraoperative PE presenting with hypotension and hypoxemia for whom the ECG finding of SIQIIITIII was key in identifying acute cor [ncbi.nlm.nih.gov]

Adrenal Insufficiency

Unexplained hypotension may be a manifestation of an adrenal insufficient state in patients with a history of corticosteroid therapy on hemodialysis. [ncbi.nlm.nih.gov]

ACTH suppression -> adrenal atrophy ADRENAL CRISIS concurrent illness, surgery, failure to take medications GI: abdominal pain, vomiting and diarrhoea CVS: dehydration, hypotension [lifeinthefastlane.com]

A 78-year-old Japanese man with fatigue, appetite loss, skin hyperpigmentation, hypotension and hypoglycemia, visited our hospital to evaluate an abnormal chest X-ray and [ncbi.nlm.nih.gov]

Hyponatremia

After several weeks of suffering from gastroenteritis with vomiting, she presented with disturbance of consciousness, hypotension, dehydration, and severe hyponatremia (108 [ncbi.nlm.nih.gov]

Hypovolemia or Hypotension: For patients who develop hypovolemia or hypotension while receiving VAPRISOL, VAPRISOL should be discontinued, and volume status and vital signs [vaprisol.com]

He was in poor general condition, hypotensive, and he had dry mucous membranes and skin as well as mucosa hyperpigmentation. [ncbi.nlm.nih.gov]

Ascending Cholangitis

[…] stones (28%-70%) • Recent cholecystectomy • Endoscopic manipulation or ERCP, cholangiogram • History of cholangitis • Immunocompromised • Malignancy (10-57%) • Sepsis • Hypotension [slideshare.net]

[…] the more severe, life-threatening form, known as toxic cholangitis or cholangitis with sepsis, patients have purulent biliary tree contents, as well as evidence of sepsis, hypotension [bestpractice.bmj.com]

A minority of patients present in shock with hypotension and altered mentation. [ncbi.nlm.nih.gov]

Septicemia

Septic shock• Sepsis with– Hypotension, for at least 1 h, despite adequate fluidresuscitation– Need for vesopressor9 10. [slideshare.net]

Abstract Purpose of review Norepinephrine is the first-line agent recommended during resuscitation of septic shock to correct hypotension due to depressed vascular tone. [doi.org]

Hypotension (low blood pressure) is an unfavorable sign. [healthcentral.com]

Kounis Syndrome

She undergoes fluid resuscitation followed by epinephrine drip for persistent hypotension. [ahajournals.org]

Emergency medicine team with the doctor was sent to an 87 year old woman who had an altered mental state, hypotension and urticaria. [eusem.org]

It can cause hypersensitivity reactions, leading to hypotension, rash, pulmonary edema, and, very rarely, Kounis syndrome (KS). [cureus.com]

Addison Disease

[…] of hypotension in these individuals. [ncbi.nlm.nih.gov]

During admission for evaluation of hypotension, she was also detected to have hyponatremia. Hyponatremia and hypotension failed to improve despite fluid resuscitation. [ncbi.nlm.nih.gov]

Addisonian (adrenal) crisis: acute complication of adrenal insufficiency (circulatory collapse, dehydration, hypotension, nausea, vomiting, hypoglycemia); usually precipitated [unboundmedicine.com]

Jarisch Herxheimer Reaction

De Jarisch-Herxheimerreactie A 73-year-old man presented with fever and hypotension, which had developed a few hours after receiving treatment with benzyl-penicillin for secondary [ntvg.nl]

She became tachycardic and hypotensive after her first dose of antibiotic, and she developed disseminated intravascular coagulation. [scholars.northwestern.edu]

Penicillin given on the first day and tetracycline on subsequent days to avoid severe Jarisch-Herxheimer reactions, has the disadvantage of a longer period of spirochetemia and hypotension [ncbi.nlm.nih.gov]

Cinchonism

Patients treated with quinine may also suffer from hypoglycemia (especially if administered intravenously ) and hypotension (low blood pressure ). [academickids.com]

Patients treated with quinine may also suffer from hypoglycemia (especially if administered intravenously) and hypotension (low blood pressure). [the-medical-dictionary.com]

Procainamide's ganglion-blocking properties may lead to periperal vasodilation and systemic hypotension. [emedicine.medscape.com]

Anaphylaxis

Use of vasopressors should be considered if hypotension persists. [ncbi.nlm.nih.gov]

Hypotension often resolves after epinephrine is given. [merckmanuals.com]

These patients may have resistant severe hypotension, bradycardia, and a prolonged course. [aafp.org]

Benzodiazepine Overdose

Although rare, this may result in hypotension, cardiac dysrhythmias, lactic acidosis, seizures, or coma. [emedicine.medscape.com]

Coma, life-threatening hypotension, bradycardia and clinically significant respiratory depression are rare if only a benzodiazepine has been taken. [mhra.gov.uk]

Aggressive/expectant airway management for frank/anticipated inadequacy of protective airway reflexes Supine/Trendelenburg positioning and aggressive IV fluid therapy for hypotension [anesth.unboundmedicine.com]

Pericardial Effusion

[…] physicians must maintain vigilance in suspecting pericardial effusion and tamponade in patients with known or suspected malignancy who present with tachycardia, dyspnea, and hypotension [ncbi.nlm.nih.gov]

Pericardial effusion is initially asymptomatic, but cardiac tamponade has a distinct clinical presentation, including hypotension, tachycardia, jugular venous congestion, [amboss.com]

These three signs (hypotension, muffled heart sounds, and jugular distension) are known as the classic Beck triad of cardiac tamponade. [study.com]

Hemothorax

Marked blood loss produces hypotension and shock. [symptoma.com]

Remember the principle of permissive hypotension, as excessive fluid resuscitation can wash out clotting factors and lead to further bleeding. [medictests.com]

Positive pressure ventilation - +/- intubation and ventilation Cardiac Tamponade - penetrating wound (usually) - Beck's triad (hypotension, distended neck veins, muffled [fprmed.com]

Cardiogenic Shock

He is profoundly hypotensive with low O2 sats and obvious CHF. The patient’s blood pressure will transiently respond to fluid resuscitation. [emsimcases.com]

Fluid resuscitation may improve the patient�s cardiac output and hypotension temporarily and buy time for definitive intervention. � Gavin Joynt April 2003 [aic.cuhk.edu.hk]

After the initiation of intravenous diltiazem drip, she developed hypotension, bradycardia, then asystole cardiac arrest. [ncbi.nlm.nih.gov]

Shy-Drager Syndrome

Postural hypotension: a report of three cases. J Am Heart J1925;1:73–86. ↵ Lewis P. Familial orthostatic hypotension. Brain1964;87:719–27. ↵ Shy GM, Drager GA. [jnnp.bmj.com]

Postural hypotension: a report of three cases. J Am Heart J 1925 ; 1 : 73 –86. ↵ Lewis P. Familial orthostatic hypotension. [jnnp.bmj.com]

CHRONIC orthostatic hypotension may develop in the course of a number of different neurologic diseases.1-3 Among others, we have encountered it in multiple sclerosis and in [jamanetwork.com]

Upper Gastrointestinal Bleeding

Worrisome signs are tachycardia, hypotension (systolic blood pressure < 90 mm Hg), orthostatic hypotension, and findings indicative of poor perfusion such as cool extremities [symptoma.com]

[…] malaise/weakness fever dizziness Physical exam positive stool guiaic hypotension tachycardia fever Evaluation CBC recall that hematocrit is not an accurate measure of blood [medbullets.com]

[…] and need for endoscopic intervention advanced age > 60 years severe comorbidity active bleeding witnessed hematemesis, red blood per NG tube, bright red blood per rectum hypotension [medbullets.com]

Hypovolemic Shock

CONCLUSION: The shock bowel sign and the CT hypotension complex are frequently associated with hypotension from causes other than trauma-induced hypovolemic shock, such as [ncbi.nlm.nih.gov]

Evaluation of Orthostatic Hypotension FIGURE 1. Algorithm for the evaluation of orthostatic hypotension. [aafp.org]

Between 1944 and 1960, we have seen the occurrence of shock or hypotension in 10 adult patients with the nephrotic syndrome. [annals.org]

Pneumothorax

Hypoxia and hypotension are characteristic of tension pneumothorax. [symptoma.com]

The classic presentation will be a patient in distress with tachycardia, tachypnea, hypotension and hypoxia. [cdemcurriculum.com]

Physical signs include respiratory distress, tachypnea, absent breath sounds, decreased tactile fremitus, tachycardia, hypotension, pulsus paradoxus and jugular venous distension [symptoma.com]

Splenic Rupture

When splenic rupture is indicated by abdominal pain, tachycardia, or hypotension in a patient with splenomegaly, abdominal examination should be performed immediately, and [ncbi.nlm.nih.gov]

Pain in the upper left abdominal quadrant, hypotension, pallor, tachycardia and abdominal distention are main symptoms. [symptoma.com]

While undergoing evaluation for his facial trauma, the patient became severely hypotensive. [ncbi.nlm.nih.gov]