Hypotension

Hypotension

Hypotension
-Cardiogenic Shock
-Defined as widespread failure of inadequate tissue perfusion resulting in metabolic demands not being met
-Caused by inadequate cardiac output
-Usually form left sided heart failure except with right ventricular infarct
-Hypotension and Tachycardia present
-Signs of left side failure-JVD, pulmonary edema, diaphoresis
-Primary cause-myocardial ischemia
-Valvular dysfunction, persistent tachycardia, or trauma can cause
-Treat by supporting blood pressure, correcting underlying cause, and oxygenation
-May need to intubate and place on mechanical ventilator
-Support blood pressure with vasopressors (dopamine, levophed)


-Orthostatic Hypotension
-Means a decrease in both systolic and diastolic pressure on standing.
-Most clinicians consider a 20 mmHg drop positive
-Can be acute or chronic
-Causes for acute orthostatic hypotension
-anatomic variation
-altered body chemistry
-drug effect
-Volume depletion *****
-Antidepressants
-physical exhaustion
-pregnancy

-Chronic-can be idiopathic or secondary to another disease state
-Diseases-adrenal insufficiency, diabetes, porphyria, intracranial tumors, cerebral infarcts, Wernickes encephalopathy

-Treatment can include volume replacement, stopping offending medicine if possible, or treating underlying disease
-Make sure fall precautions are in place