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In this episode, we review hypotension, a clinical state of abnormally low blood pressure that can lead to inadequate tissue perfusion and organ dysfunction. We discuss the major underlying mechanisms, including hypovolemia, distributive shock, cardiogenic causes, and obstructive physiology, along with common risk factors such as dehydration, hemorrhage, sepsis, medications, endocrine disorders, and cardiac disease. The episode highlights classic signs and symptoms including dizziness, syncope, weakness, altered mental status, tachycardia, and signs of shock, emphasizing the importance of identifying the underlying cause rather than treating the blood pressure value alone. We also review key components of the diagnostic evaluation, including orthostatic vitals, laboratory studies, EKG, and bedside assessment of perfusion, as well as initial management with fluid resuscitation, vasopressors when indicated, and rapid treatment of the underlying etiology.

References

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