Orthostatic Hypotension - Management Algorithm
Positive orthostatic vital signs defined as one of the following (within 3 minutes of standing):
 - ↓ SBP > 20 mm Hg
 - ↓ DBP > 10 mm Hg
 - ↑ HR > 30 bpm
 • HR increasing appropriately? No → Medication reconciliation, Assess for dysautonomia
 • Hypovolemic? Yes → Medication reconciliation, Resuscitate
 • Volume overloaded or at risk of overload? No → Fludrocortisone
 • Supine hypertension? No → Midodrine, Yes → Consider pyridostigmine

Satya Patel, MD @SatyaPatelMD

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