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