Anxiety & Hypotension & Pelvic Hematoma: Causes & Reasons

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Patient File

Sex unknown, Age unknown

Reported Symptoms

Anxiety, Hypotension, Pelvic Hematoma,

Negated

None

Unsure

None

Possible Causes

Ectopic Pregnancy

MAIN OUTCOME MEASURES: Post-traumatic stress disorder (PTSD) was measured using the Post-traumatic Diagnostic Scale (PDS), and anxiety and depression using the Hospital Anxiety [ncbi.nlm.nih.gov]

Systemic hypotension is a late marker of shock after trauma: a validation study of ATLS principles in a large national sample. Am J Surg 2006; 192:727. [coreem.net]

If the tube has ruptured, the patient may present in shock with tachycardia and hypotension. [web.archive.org]

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Penetrating Abdominal Trauma

Painful injuries often produce significant anxiety. Anxiolytics help to calm the patient, provide some amnesic effects and reduce the quantity of analgesia needed. [emsworld.com]

Intraoperative hypotension (25%) and blood transfusion (39%) were common. [ncbi.nlm.nih.gov]

Predictors of immediate celiotomy were hypotension (p 0.03), anteriorly located entrance wounds (p 0.0005), and transaxial wounds (p 0.03). [ncbi.nlm.nih.gov]

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Hypovolemic Shock

[…] in the left retroperitoneal space and pelvic cavity. [ncbi.nlm.nih.gov]

Symptoms include: Anxiety Low or no urine output Profuse sweating Dizziness Confusion Loss of consciousness Chest pain Tachycardia with weak pulse Hypotension Decreased urine [symptoma.com]

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]

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Leaking Aortic Aneurysm

[…] of presentations such as semiconsciousness, unconsciousness, difficulty breathing, weakness, nausea, headache, slurred speech, chest pain, allergic reaction, seizure, and anxiety [books.google.com]

[…] case CCC — Permissive hypotension Journal articles Al-Hashimi, M, Thompson J. [lifeinthefastlane.com]

[…] buttocks, or legs abdominal rigidity severe, sudden or persistent pain in the lower back paleness · rapid pulse or heartbeat sensations dry skin/mouth, excessive thirst anxiety [wisconsinheartgroup.com]

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Bradycardia

660.8 fetal fetopelvic disproportion 653.4 fever during labor 659.2 fibroid (tumor) (uterus) 654.1 fibromyomata 654.1 forelying umbilical cord 663.0 fracture of coccyx 665.6 hematoma [icd9data.com]

Conditions include: High blood pressure Alcoholism High anxiety Illicit drug use and smoking can also put you at high risk of developing bradycardia. [mercy.com]

Atropine was successful in treating bradycardia and associated hypotension. [ncbi.nlm.nih.gov]

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Hemopneumothorax

Pelvic pain and a subcutaneous hematoma were detected. Furthermore, abdominal pain and guarding were observed during palpation. [file.uroturk.org.tr]

Increased dyspnea goes along with the increased hypoxemia, as does anxiety. [quizlet.com]

[…] of the sudden spontaneous appearance of respiratory complaints, such as dyspnea and chest pain, but up to 30% of individuals suffer from hypovolemic shock, manifesting as hypotension [symptoma.com]

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Abruptio Placentae

660.8 fetal fetopelvic disproportion 653.4 fever during labor 659.2 fibroid (tumor) (uterus) 654.1 fibromyomata 654.1 forelying umbilical cord 663.0 fracture of coccyx 665.6 hematoma [icd9data.com]

[…] bleeding (intra-uterine bleeding): rapid or weak or undetectable pulse, very low or undetectable blood pressure; tachypnoea, pallor, sensation of cold, damp skin, agitation and anxiety [medicalguidelines.msf.org]

A pregnant woman has a greater blood volume thus hypotension may not be as profound as expected particularly if hypertension was present previously. [sharinginhealth.ca]

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Amniotic Fluid Embolism

660.8 fetal fetopelvic disproportion 653.4 fever during labor 659.2 fibroid (tumor) (uterus) 654.1 fibromyomata 654.1 forelying umbilical cord 663.0 fracture of coccyx 665.6 hematoma [icd9data.com]

[…] cannot be otherwise explained DDX (long): myocardial infarction, pulmonary embolism, air embolism, anesthetic complications, anaphylaxis, and eclampsia and sepsis Period of anxiety [smfm.org]

[…] salvage and transfusion through a leukocyte depletion filter was attempted after the diagnosis of AFE was made, but the attempted transfusion was immediately followed by hypotension [ncbi.nlm.nih.gov]

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Postpartum Hemorrhage

Concealed pelvic hematomas with ongoing blood loss may also be masked initially. [clinicaladvisor.com]

Mood and anxiety disorders We restricted the primary analyses to a subcohort of 106 000 women with diagnoses for mood or anxiety disorders (as inpatients or outpatients; ICD [bmj.com]

palpitations, dizziness, hypotension, tachycardia, weakness, pallor). [symptoma.com]

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Traumatic Urinary Bladder Rupture

Additionally, the bladder may assume a teardrop shape secondary to compression from a pelvic hematoma. [emedicine.medscape.com]

Determine the patient’s and family’s level of anxiety and their ability to cope with stressors. [medical-dictionary.thefreedictionary.com]

Presenting features There may be hypovolaemia, hypotension and shock. Clinical signs of bladder injury are relatively nonspecific. [patient.info]

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Urinary Tract Injury

Surgical measures for pelvic fracture and pelvic hematoma: - stabilization and packing. 16. [slideshare.net]

Determine the patient’s and family’s level of anxiety and their ability to cope with stressors. [medical-dictionary.thefreedictionary.com]

Presenting features There may be hypovolaemia, hypotension and shock. Clinical signs of bladder injury are relatively nonspecific. [patient.info]

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Personality Disorder

etc. • Unable to detect pelvic and small vessel thrombosis. • Operator dependent results 21. [slideshare.net]

J Anxiety Disord. 2009;23(8):1011-23. [ Links ] Organização Pan-Americana da Saúde (OPAS). [scielo.br]

[…] thrombolysis or systemic thrombolysis COMPLICATIONS venous infarction leading to gangrene PE postphlebitic syndrome Fluid sequestration in the affected limb and SIRS leading to hypotension [litfl.com]

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Splenic Rupture

Following the CT, the radiologist immediately called with preliminary results concerning for splenic laceration and hematoma with hemorrhagic abdominal and pelvic ascites [westjem.com]

This might include a rapid pulse, low blood pressure, rapid breathing, paleness, and anxiety. [en.wikipedia.org]

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

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Constipation

Digital examination revealed a pulseless tumor and pelvic CT and US showed the big cystic lesion. [doi.org]

Anxiety and depression were assessed with the Beck Depression Inventory and the State-Trait Anxiety Inventory. [ncbi.nlm.nih.gov]

On examination, she was noted to be afebrile, hypotensive, and tachycardic with abdominal tenderness. [ncbi.nlm.nih.gov]

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Septic Shock

The most common complication is low-grade fever, but rarely, pelvic infection, groin hematoma, iliac artery perforation, transient buttock ischemia, transient foot ischemia [emedicine.medscape.com]

confusion, lethargy, anxiety, nausea, and vomiting. How do doctors diagnose septic shock? [medicinenet.com]

[…] different radial artery invasive blood pressure changes in an arm elevation test, which could be applied as a new method to distinguish hypovolemic shock and septic shock from hypotension [ncbi.nlm.nih.gov]

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Renal Salt-Wasting Syndrome

Multiple facial bone fractures, subcutaneous emphysema in the right chest along with right lung contusion and multiple pelvic bone fractures were noted. [sjkdt.org]

Advanced symptoms include muscle cramps, lightheadedness, dizziness or vertigo, feelings of anxiety or panic, increased heart rate or slowed heart rate, low blood pressure [en.wikipedia.org]

Seven of seventy patients treated with cisplatin over 18 months developed salt-wasting nephropathy and orthostatic hypotension. [annals.org]

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Hemodialysis

[…] in the left retroperitoneal space and pelvic cavity. [ncbi.nlm.nih.gov]

Depression and anxiety in hemodialysis patients. Journal of Mashhad University of Medical Sciences. 2008;51(3):171-6. [journals.sbmu.ac.ir]

OBJECTIVE: Hypotension during hemodialysis (HD) is the most common complication that negatively affects the quality of life of patients. [ncbi.nlm.nih.gov]

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Abdominal Visceral Abscess

Imaging performed after catheter insertion may show a significant pelvic hematoma or may manifest later as pain or hemodynamic instability. [pubs.rsna.org]

Vomiting purple / black blood Stools with blood like tar (melaena) May be abdominal or epigastric lumps or masses Sweating of head Heartburn Afternoon mental depression and anxiety [americandragon.com]

Sepsis definitions 24 Systemic inflammatory response syndrome (SIRS) a Severe sepsis Septic shock Temperature 38 C or SIRS lactic acidosis or hypotension Severe sepsis hypotension [obgyn.onlinelibrary.wiley.com]

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Gastritis Medicamentosa

Retroperitoneal hematoma caused by a ruptured pelvic varix in a patient with iliac vein compression syndrome. J Vasc Interv Radiol 2003;14:387–390. 7. [vasculardiseasemanagement.com]

Treatment of recurrent aphthous ulcers with Aureomycin mouth Up to a third of the population will suffer from an anxiety disorder or and it was amazing to find that I wasn [ict-accordance.eu]

Acute hemorrhagic or erosive gastritis that presents with upper GI tract bleeding, tachycardia, and hypotension Uncontrolled pain or vomiting Coagulopathy from med... [5minuteconsult.com]

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Splenic Hematoma

@inbook{dfb1cccb290a4e0fab4164f2ec127e32, title "Calcified splenic hematoma presenting as a pelvic mass. [tmu.pure.elsevier.com]

This can cause: Blurred vision Confusion Light-headedness Fainting Signs of shock, including restlessness, anxiety, nausea, and paleness How Is a Ruptured Spleen Diagnosed [webmd.com]

Case Report A 35 years male was admitted with abdominal pain, tachycardia, hypotension, pallor and anaemia (Hb – 5.0 gm/ dl). [tropicalgastro.com]

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Traumatic Aortic Rupture

Head injury and pelvic fractures may be further predictors of TAR. [symptoma.com]

Symptoms are caused by a decrease of blood flowing to the rest of the body, and can include: Anxiety and a feeling of doom Fainting or dizziness Heavy sweating (clammy skin [medlineplus.gov]

Each patient's chart was evaluated for chest pain, respiratory distress, thoracic back pain, hypotension, hypertension, and decreased femoral pulses. [ncbi.nlm.nih.gov]

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Puerperium

(pubis) 665.7 Pelvic hematoma [0-2,4] Hematoma of vagina 665.8 Other specified obstetrical trauma [0-4] 665.9 Unspecified obstetrical trauma [0-4] 666 Postpartum hemorrhage [theodora.com]

Prevalence and course of anxiety disorders (and symptom levels) in men across the perinatal period: A systematic review. [bjp.rcpsych.org]

Septic shock can be identified within a clinical construct of sepsis with persistent hypotension requiring vasopressors to maintain mean arterial pressure (MAP) 65 mm Hg and [contemporaryobgyn.net]

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Subdural Hematoma

[…] inflammation Symptoms of Subdural Hematoma in Infants Difficulties with feedings Shrill, high-pitched crying Bulging from the infant’s soft spot on top of the head Extreme [birthinjuryguide.org]

Complications that may result include: Brain herniation (pressure on the brain severe enough to cause coma and death) Persistent symptoms such as memory loss, dizziness, headache, anxiety [nlm.nih.gov]

Adult patients with spontaneous intracranial hypotension (age 18 years) were enrolled. [ncbi.nlm.nih.gov]

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Cerebral Salt-Wasting Syndrome

Multiple facial bone fractures, subcutaneous emphysema in the right chest along with right lung contusion and multiple pelvic bone fractures were noted. [sjkdt.org]

Advanced symptoms include muscle cramps, lightheadedness, dizziness or vertigo, feelings of anxiety or panic, increased heart rate or slowed heart rate, low blood pressure [en.wikipedia.org]

A 76-year-old white man was evaluated for a syndrome of hyponatremia, hypotension, and high urinary sodium excretion. [ncbi.nlm.nih.gov]

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Uterine Atony

[…] organs O71.6 Obstetric damage to pelvic joints and ligaments O71.7 Obstetric hematoma of pelvis O71.8 Other specified obstetric trauma O71.81 Laceration of uterus, not elsewhere [icd10data.com]

This obviously heightens the anxiety of the operator, and should the operator be inattentive to detail because of the pressures of the situation or be unfamiliar with the [glowm.com]

[…] undergoing neuraxial anesthesia for cesarean delivery would be associated with greater uterine atony, as measured by supplemental uterotonic agent use and blood loss, and less hypotension [ncbi.nlm.nih.gov]

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Bradyarrhythmia

660.8 fetal fetopelvic disproportion 653.4 fever during labor 659.2 fibroid (tumor) (uterus) 654.1 fibromyomata 654.1 forelying umbilical cord 663.0 fracture of coccyx 665.6 hematoma [icd9data.com]

Effect of anxiety and depression on the fatigue of patients with a permanent pacemaker. Archives of Medical Science-Atherosclerotic Diseases, 3, 8-17. [journals.sagepub.com]

CB1 receptor activation in animal studies have caused hypotension. CB2 receptors seem to be involved in some degree of cardioprotective effect. [shmabstracts.com]

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Bilateral Massive Adrenal Hemorrhage

Whole-body computed tomography did not show any evidence of spinal, thoracic, abdominal or pelvic injury. [jintensivecare.biomedcentral.com]

Moreover, psychiatric disorders have been documented in these patients, ranging from anxiety to major depression [ 22 ]. [intechopen.com]

At admission, the man presented with fever, severe hypotension, hyperazotemia, acidosis, normonatremia and hypocoagulability, while the girl with severe hypotension, fever [ncbi.nlm.nih.gov]

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Urethral Trauma

At this time, the pelvic hematoma has stabilized and hemorrhage is less of a concern. [traumawiki.opus12.org]

For about a day I thought of the possibility that it might be inflated by anxiety or there was some sort of psychosomatic element to it. [healthboards.com]

[…] with warfarin, and amyloidosis resulting in stage II diastolic heart failure and nephrotic syndrome presented to the emergency department with nausea, lightheadedness, and hypotension [jamanetwork.com]

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Muscle Spasm

[…] in spasm, and the diseases of the abdominal and pelvic organs that can cause an IPM reflex spasm. [lijecnicki-vjesnik.hlz.hr]

Both of these may be caused by anxiety. Causes of Muscle Spasms From Anxiety Muscle spasms occur often, and not just in those with anxiety. [calmclinic.com]

[…] mid-deċiżjoni tat-# ta’ Novembru # (il-kredibbiltà u s-saħħa probatorja tagħha en Allergic type reactions (eg: anaphylaxis, anaphylactic shock and anaphylactoid type reactions, hypotension [mt.glosbe.com]

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Pathological Retraction Ring of the Uterus

660.8 fetal fetopelvic disproportion 653.4 fever during labor 659.2 fibroid (tumor) (uterus) 654.1 fibromyomata 654.1 forelying umbilical cord 663.0 fracture of coccyx 665.6 hematoma [icd9data.com]

Encourage verbalization of anxiety/fear/ concerns. b. Explain all procedures—to minimize anxiety/fear, encourage cooperation/participation in care. c. [brilliantnurse.com]

To prevent hypotension and improve blood supply to the uterus encourage side lying position. Encourage voiding every 2 hours. [ashrafkamal77.forumarabia.com]

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