Hypotension resident survival guide: Difference between revisions

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* Avoid or limit the use of [[alcohol]]
* Avoid or limit the use of [[alcohol]]
* Avoid standing for prolonged periods of time
* Avoid standing for prolonged periods of time
* Don't cross legs while in a sitting position
* Do not cross legs while in a sitting position


==References==
==References==

Revision as of 14:31, 9 August 2013

Hypotension Microchapters

Home

Patient Information

Overview

Historical Perspective

Pathophysiology

Causes

Differentiating Hypotension from other Diseases

Epidemiology and Demographics

Risk Factors

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

Chest X Ray

CT

MRI

Echocardiography or Ultrasound

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Hypotension resident survival guide On the Web

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Definition

Hypotension is low blood pressure, especially in the arteries of the systemic circulation. It is considered to be a systolic BP of less than 90mmHg or diastolic of less than 60mmHg.

Causes

Life Threatening Causes

Common Causes

Management

Algorithm summarizing the management of hypotension is shown below

 
 
 
 
 
 
 
 
 
 
 
 
 
 
BP measurement
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Systolic BP < 90mmHg
Or
Diastolic BP < 60mmHg
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Hypotension
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
History and Symptoms

Dizziness or lightheadedness
Syncope (fainting)
Rapid, shallow breathing
Nausea
Blurred vision
Cold clammy, pale skin
 
 
 
 
Physical Examination

Heart (irregular beats)
Tilt table test
 
 
 
 
 
 
 
Laboratory Tests

CBC (anemia)
Glucose (Hypoglycemia, DM)
Urinalysis
Blood culture
Cortisol (Addison's disease)
BUN
 
 
 
 
EKG
Echocardiogram
Stress test
Valsalva maneuver
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Tilt table test positive
 
 
 
 
 
Tilt table test negative
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Neurocardiogenic syncope

Continue with EKG and BP monitoring
Beta blockers preferred initial treatment
Alpha agonist
SSRI
Fludrocortisone 0.1mg/day
Midodrine 2.5-10 TID
Scopolamine
Dual chamber pacing may be required
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Orthostatic hypotension
 
 
 
 
 
Postprandial hypotension

Advice to eat smaller, low carbohydrate meals
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Medical Therapy

Fludrocortisone
Pyridostigmine bromide
Erythropoietin
 
 
 
Lifestyle Modification

Regular BP monitoring with a home monitoring kit supine and prone
Maintenance of an elevated salt intake of 10g/day
Maintenance of proper fluid intake to prevent dehydration
Blood sugar control
 
 
 
 
 
 
 
 
 
 
 
 
 
 

Do's

  • Discontinue or adjust dose of medication if hypotension is caused by medication side effects

Don'ts

  • Avoid or limit the use of alcohol
  • Avoid standing for prolonged periods of time
  • Do not cross legs while in a sitting position

References

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