Hypotension: Causes & Reasons

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Possible Causes for Hypotension

Orthostatic Hypotension

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

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". [en.wikipedia.org]

Vasovagal Syncope

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

In these cases additional measures should be used to counteract hypotension. [ncbi.nlm.nih.gov]

Neurocardiogenic (vasovagal) syncope is characterized by hypotension and bradycardia. [ncbi.nlm.nih.gov]

Acute Kidney Injury

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

The cause is usually ischemic (from prolonged hypotension) or nephrotoxic (from an agent that is toxic to the tubular cells). [aafp.org]

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]

Syncope

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

We reported a 75-year-old man who had recurrent syncope attacks secondary to hypotension and reduced plasma norepinephrine (NE) levels. [ncbi.nlm.nih.gov]

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

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]

Sepsis

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

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]

Septic shock is defined as hypotension with a mean arterial pressure less than 65 mm Hg, requiring vasopressors despite adequate fluid resuscitation and/or lactic acid levels [ncbi.nlm.nih.gov]

Hypovolemia

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

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]

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]

People with orthostatic hypotension are advised to avoid sitting up or standing up suddenly; wear compression stockings; avoid medications that aggravate orthostatic hypotension [diabetesselfmanagement.com]

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

Hypotension

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

Hypotension Definition Hypotension is the medical term for low blood pressure. [medical-dictionary.thefreedictionary.com]

What Causes Orthostatic Hypotension (Postural Hypotension)? [stanfordhealthcare.org]

Low-Cardiac-Output Syndrome

[…] 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]

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

[…] whereas 94% of those surveyed sometimes or always administer corticosteroids to patients with severe low cardiac output syndrome (two or more vasoactive agents and persistent hypotension [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]

It should be part of the differential diagnosis in cases of hypotensive patient who is unresponsive to vasoactive agents. [ncbi.nlm.nih.gov]

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]

Ascending Cholangitis

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

Furthermore, some authors add hypotension and altered mental status to the Charcot triad's to form the Reynold's pentad, another diagnostic tool used to identify patients [symptoma.com]

[…] 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]

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]

Kounis Syndrome

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]

He developed constricting chest discomfort associated with dyspnea, sweating and hypotension. [revportcardiol.org]

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]

She was hyperpigmented, hypotensive and hyponatraemic despite rehydration. [ncbi.nlm.nih.gov]

Pulmonary Embolism

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

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

KEYWORDS: Cardiopulmonary arrest; Hypotension; Surgical embolectomy; Thrombolysis [Indexed for MEDLINE] Free full text [ncbi.nlm.nih.gov]

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]

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]

Shortly afterward, she became hypotensive and required fluid resuscitation. [ncbi.nlm.nih.gov]

Anaphylaxis

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

The hypotensive state was refractory to large amount of crystalloid infusion and a series of examinations were performed to determine the shock etiology. [ncbi.nlm.nih.gov]

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

Cinchonism

[…] irreversible tunnel vision and very severe visual impairment.Patients treated with quinine may also suffer from low blood sugar, especially if it is administered intravenously, and hypotension [en.wikipedia.org]

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

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]

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]

We suggest that vasopressin may be the drug of choice in patients with Shy-Drager syndrome with refractory hypotension. [ncbi.nlm.nih.gov]

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]

Signs and symptoms of hypotension are present: Weak or absent peripheral pulses; mottled extremities from low flow states; diaphoresis; and pallor. [cathlabdigest.com]

The characteristic features are: poor tissue perfusion: poor cerebral function cool extremeties oliguria hypotension poor cardiac output Cardiogenic shock is most commonly [gpnotebook.co.uk]

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]

Nystagmus Hallucinations Slurred speech Ataxia Coma Hypotonia Weakness Altered mental status, impairment of cognition Amnesia Paradoxical agitation Respiratory depression Hypotension [emedicine.medscape.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]

CT hypotension complex refers to the predominantly abdominal imaging features that occur in the context of profound hypotension. [radiopaedia.org]

Renal Salt-Wasting Syndrome

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

[…] external resources DiseasesDB 32234 eMedicine ped/354 Cerebral salt wasting syndrome ( … Wikipedia salt depletion syndrome — salt losing syndrome vomiting, dehydration, hypotension [medicine.academic.ru]

Its hallmarks are renal excretion of sodium and loss of extracellular fluid volume, producing signs and symptoms of hyponatremia and hypotension. [americannursetoday.com]

Splenic Rupture

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

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]

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

Theophylline Poisoning

CAVEAT: Barbiturates can precipitate hypotension. Phenobarbital has the added advantage of enhancing the hepatic metabolism of theophylline. [emedicine.medscape.com]

Clinical features included nausea, tremor, delirium, hypotension and cardiac arrhythmias, metabolic acidosis, hyperglycemia, hypokalemia and hypophosphatemia. [ncbi.nlm.nih.gov]

Severe toxicity, such as seizures, dysrhythmias, and hypotension, usually does not occur with acute overdose until levels are 80-100 mcg/mL. [emedicine.medscape.com]

Tricyclic Antidepressant Overdose

The overall frequency of admission hypotension (systolic BP less than 95 mmHg) was 34% (22 of 64 patients). [ncbi.nlm.nih.gov]

Systemic arterial hypotension is a frequent occurrence in major overdoses. [ncbi.nlm.nih.gov]

Class II agents (beta-blockers) may also precipitate hypotension and cardiac arrest. [ncbi.nlm.nih.gov]

Capillary Leak Syndrome

He was hypotensive, tachycardic, and edematous over the trunk and all four limbs. [ncbi.nlm.nih.gov]

The leak phase follows with oliguria, arterial hypotension and rapid development of edema of the face or the upper limbs but sparing the lungs. [orpha.net]

The serum of the patient was stored soon after the onset of hypotensive crisis and analyzed to profile possible mediators responsible for the capillary leak. [ncbi.nlm.nih.gov]

Ischemic Bowel Disease

[…] mucosal: extends down to the muscularis mucosa (hypotension) mural: involves the mucosa and submucosa (hypotension) transmural: involves all 3 wall layers (acute obstruction [quizlet.com]

Catastrophic hypotensive states naturally affect perfusion in all mesenteric vessels and atherosclerotic narrowing, when it does occur, is typically widespread and affects [pathwaymedicine.org]

Blood volume redistribution with transient episodes of hypotension, especially during postoperative hemodialysis, may be significant. [ncbi.nlm.nih.gov]