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31 Possible Causes for Hypotension, Increased Area of Cardiac Dullness

  • Congestive Heart Failure

    After cardioversion, refractory hypotension and cardiopulmonary arrest occurred. An arterial blood gas analysis showed marked lactic acidosis.[] Therefore, ASV may be effective for treating CHF in HD patients with LV dysfunction and chronic hypotension.[] However, the patient's renal function and hyperkalemia worsened, and the blood eosinophil count increased without signs of dehydration or hypotension.[]

  • Pericardial Effusion

    Considerable amounts of pericardial fluid may muffle heart sounds, increase the area of cardiac dullness, and change the size and shape of the cardiac silhouette.[] […] physicians must maintain vigilance in suspecting pericardial effusion and tamponade in patients with known or suspected malignancy who present with tachycardia, dyspnea, and hypotension[] Pericardial effusion is initially asymptomatic, but cardiac tamponade has a distinct clinical presentation, including hypotension , tachycardia , jugular venous congestion[]

  • Aortic Valve Stenosis

    If unexpectedly poor exercise tolerance is demonstrated or if there is exercise-induced hypotension or ventricular arrhythmia, aortic valve replacement seems wise, although[] Phenylephrine Hypotension (vagally mediated, medication-induced) Increase MAP with AS and hypotension Decrease LVOT gradient in HCM Bolus: 0.1 to 0.5 mg IV every 10 to 15[] If vasodilators, such as nitrates, are used, caution should be exercised since these medications can cause hypotension and other physiological effects that may exacerbate[]

  • Cardiac Tamponade

    Of the 7 hypotensive or normotensive patients diagnosed with cardiac tamponade, 4 underwent successful pericardiocentesis while awaiting surgery.[] KEY POINTS Slow accumulation of pericardial fluid can result in edema, whereas rapid accumulation leads to hypotension.[] Three of the 10 presented as the sudden onset of fatal electromechanical dissociation, 6 presented with hypotension, and 1 was normotensive on presentation.[]

  • Hemopericardium

    Massive bleeding through the chest drains with hypotension required emergency reoperation in the intensive care unit.[] The patient collapsed acutely 15 min following stent placement with hypoxemia and hypotension.[] The patient had a large hyperdense pericardial effusion caused by accumulation of bloody fluid, leading to hypotension and shock.[]

  • Scoliosis

    Repeat prone positioning resulted in a recurrence of hypotension. However, hemodynamic stabilization was restored and maintained by repositioning chest pads caudally.[] Due to hypotension induced by local anesthetic (LA) epidural diffusion, the patient received intravenous hydration and vasopressor.[] Blood loss is higher in children with muscular dystrophy, hypotensive anesthesia has been helpful.[]

  • Suppurative Pericarditis

    Patients with large pericardial effusions have an area of increased dullness at the base of the heart in addition to generalized enlargement of the area of cardiac dullness[] On admission, the patient presented: heart rate of 186 beats per minute; no hypotension (blood pressure at 106/65 mmHg); respiratory frequency of 50 breaths per minute; fever[] Patients may present with hypotension and clinical signs of sepsis (rare with empyema alone).[]

  • Malignant Pericardial Effusion

    Rapid reactive reaccumulation of the pericardial fluid was thought to be a cause of hypotension.[] Shortly after completing treatment, she presented with weakness and was found to be hypotensive on physical exam.[] No hypotension and retrosternal pain were observed. Cisplatin administered directly into pericardial space (CAP) seems to be effective and safe.[]

  • Cardiomyopathy

    […] symptoms: Shortness of breath Exercise intolerance Chronic fatigue Paroxysmal Nocturnal Dyspnea (PND) Abdominal distention Bilateral peripheral edema Palpitation Orthostatic hypotension[] They are usually well tolerated but may lead to bradycardia, hypotension and fluid retention, and should be avoided in infants with decompensated HF. 6 Although widely practiced[] There are five useful clinical signs to establish the presence and severity of cardiomyopathy: general appearance (cachexia and dyspnea at rest indicate severe impairment), hypotension[]

  • Mallory-Weiss Syndrome

    ., hematochezia, were significantly different in hypotensive patients. 2) Active bleeding but not stigmata was associated with higher transfusion requirements. 3) Rebleeding[] In such circumstances patients may experience shock, hypotension and poor general condition, which necessitates immediate treatment.[] In adults, shock occurs in as many as 20% of patients bleeding from Mallory-Weiss tears who present to emergency departments; as many as 45% of patients develop postural hypotension[]

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