Other disease processes

Cardiac obstruction, due to pericardial tamponade or tension pneumothorax for example, can rapidly cause severe hypotension. The hemodynamic features of cardiac obstruction (for the left heart) are reduced diastolic compliance, reduced preload, and a decreased cardiac output.

Anaphylaxis refers to an antigen-provoked and IgE-mediated activation of mast cells and basophils with release of various mediators. Acute hypotension may complicate untreated anaphylaxis and is primarily the consequence of hypovolemia (due to elevated microvascular permeability and shifting of intravascular fluid away from the intravascular space), venodilatation with decreased venous return, and myocardial depression. Both cardiac filling pressures and cardiac output may be reduced.

An insufficient intravascular fluid volume is also the cause of neurogenic hypotension complicating spinal cord injury. Hypotension is related to an acute decrease in systemic vascular resistance caused by interruption of sympathetic nerves distal to the site of injury. Cardiac output is usually maintained or, in response to vasodilatation, increased. If the acute phase of neurogenic hypotension is bridged with adequate volume therapy and, when indicated, pressor agents, autoregulatory mechanisms will lead to a restoration of sufficient blood pressure within weeks or months in the majority of cases.

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Sleep Apnea

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