Approach to the Hypotensive Patient - Differential Diagnosis Framework for Hypotension Blood Pressure = Heart Rate x Stroke Volume x Peripheral Vascular Resistance Bradycardia (inadequate cardiac output): • Sinus bradycardia • AV blocks • Sick sinus syndrome Tachycardia (inadequate filling time): • Sinus tachycardia • Atrial tachycardias • Ventricular arrhythmia Decreased Preload: • Volume depletion • Pulmonary embolism • Pericardial tamponade • Tension pneumothorax • Right ventricular dysfunction • Vasodilatory meds • Adrenal insufficiency (MC) Cardiac Contractility: • Left ventricular dysfunction - Myocardial infarction - Free wall rupture - Myocarditis - Papillary muscle rupture • Acute mitral regurgitation • Aortic regurgitation • Aortic stenosis • Meds: negative inotropes Decreased Afterload: • Sepsis • Anaphylaxis • Adrenal insufficiency (GC) • Vasodilatory meds • Neurogenic #Hypotension #hypotensive #differential #diagnosis #causes #Hypotensive
