Common causes in intensive care

• Idiopathic/essential

• Agitation/pain, especially where muscle relaxants are used

• Excessive vasoconstriction, e.g. cold, vasopressor drugs

• Head injury, cerebrovascular accidents

• Dissecting aneurysm, aortic coarctation

• Vasculitis, thrombotic thrombocytopenic purpura

• Aortic coarctation (may present acutely in adulthood)

• Endocrine, e.g. phaeochromocytoma (rare)

• Renal failure, renal artery stenosis (rare)

• Spurious — underdamped transducer system

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