Hypotension and Shock

Hypotension and Shock: Excerpt from A Pocket Manual of Differential Diagnosis

Hypovolemia
   External losses
       Hemorrhage
       Gastrointestinal loss
       Fistulae
       Renal loss
          Diuretics
          Diabetes insipidus
          Osmotic diuresis (e.g., diabetes mellitus)
          Diuretic phase of acute renal failure
          Salt-losing nephropathy
          Postobstructive diuresis
       Cutaneous loss
          Burns
          Exudative lesions
          Perspiration and insensible loss without replacement
   Internal losses
       Hemorrhage (e.g., anticoagulant therapy)
          Hemothorax
          Hemoperitoneum
          Retroperitoneal hemorrhage
          Soft tissue injury
          Fracture
       Fluid sequestration
          Ascites
          Bowel obstruction or infarction
          Peritonitis
          Phlegmon (e.g., pancreatitis)
          Budd-Chiari syndrome
Cardiovascular causes
   Arrhythmia
   Regurgitant lesions
       Acute mitral or aortic regurgitation
       Rupture of interventricular septum
       Giant left ventricular aneurysm
   Obstructive lesions
       Valvular stenosis
       Hypertrophic cardiomyopathy
       Atrial myxoma
       Intracardiac or valvular thrombus (including prosthetic valve)
   Myopathy
       Acute myocardial infarction
       Contusion
       Dilated or restrictive cardiomyopathy
       Ventricular wall defects and aneurysms
       Other myocardial disorders (associated with low cardiac output)
   Pericardial disease
       Cardiac tamponade
       Constrictive pericarditis
   Aortic lesions
       Acute dissection
       Coarctation
       Rupture (e.g., trauma or aneurysm)
   Congenital heart disease
   Vena cava obstruction
Pleuropulmonary disease
   Tension pneumothorax
   Positive pressure ventilation
   Pulmonary embolism (including thrombus, amniotic fluid, air, tumor)
   Primary or secondary pulmonary hypertension
   Eisenmenger reaction
Infection
   Septicemia
   Specific infections (e.g., dengue fever)
   Toxic shock syndrome
Anaphylaxis
Endocrine disease
   Adrenal insufficiency
   Hypoglycemia or hyperglycemia
   Hypocalcemia or hypercalcemia
   Myxedema or thyroid storm
   Pheochromocytoma
   Pituitary failure including diabetes insipidus
Hypoxia
Severe acidosis or alkalosis
Nonbacterial sepsis syndrome
Hypothermia or hyperthermia
Hepatic failure
Drugs and toxins
   Drug overdose and poisoning (e.g., barbiturates)
   Antihypertensive agents
   Other vasodilators (e.g., nitroglycerin)
   Heavy metals
   Anesthesia (e.g., propofol)
   Polycythemia vera
   Sickle cell crisis
Hyperviscosity syndrome
Neuropathic causes
   Brainstem failure
   Spinal cord dysfunction
   Autonomic insufficiency

References

1. Leier CV: Approach to the Patient with Hypotension and Shock, p. 361. See Bibliography, 5.

2. Jimenez EJ: Shock, p. 359. See Bibliography, 5.

Book Source Details

• Book Title: A Pocket Manual of Differential Diagnosis
• Author(s): Stephen N. Adler, Dianne B. Gasbarra
• Year of Publication: 1999
• Copyright Details: A Pocket Manual of Differential Diagnosis, Copyright © 1999 Lippincott Williams & Wilkins.

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More About This Book: Title: A Pocket Manual of Differential Diagnosis Authors: Stephen N. Adler, Dianne B. Gasbarra Publisher: Lippincott Williams & Wilkins Copyright: 1999 ISBN: 0-78171-943-7

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