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Arterial Diseases – Hypotension and Shock

by Joseph Alpert, MD
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    Hello. This is vascular medicine: the advanced components. And this section we'll discuss hypotension—that is, decreased blood pressure—and shock. So let's start with the definition, as we've done in each of the other cases. Hypotension, or decreased blood pressure, is a blood pressure less than 100 mmHg systolic blood pressure, where the normal is generally, in the population, about 120/80. There are common symptoms associated with decreased blood pressure: fatigue; dizziness or lightheadedness; and occasionally, even fainting. Patients may have a fast heart rate; they may have a slow heart rate. But their blood pressure is low. The skin can be warm and not very sweaty in some patients, where they're markedly vasodilated in the skin. Or they may have cool, sweaty skin when the skin is very vasoconstricted. And hypotension is very commonly related to dehydration or blood loss. Shock is more severe than hypotension. Shock is not only low blood pressure, but it is an associated decrease in blood flow to critical organs. For example, it's a life-threatening condition. It's not only low blood pressure, but the brain and the heart and the kidneys are not getting enough blood flow, and they start to malfunction. This shock usually occurs in the setting of a very serious medical illness—for example, a large heart attack (large myocardial infarction), or an overwhelming bacterial infection where the bacteria are in the bloodstream, or a serious hemorrhage. The diagnosis is usually pretty straightforward. It consists of noticing that the blood pressure is low with a blood pressure cuff. And the patients show a number of signs when they have very low blood pressure. They're often confused. In many patients, they will have cool and sweaty skin and be pale. They have low urine output, because the kidney's not getting enough blood flow. And...

    About the Lecture

    The lecture Arterial Diseases – Hypotension and Shock by Joseph Alpert, MD is from the course Arterial Diseases. It contains the following chapters:

    • Hypotension and shock - Definition
    • Hypotension and shock - Pathogenesis
    • Hypotension and shock - Therapy
    • Hypotension and shock - Summary

    Included Quiz Questions

    1. Patients with hypotension usually complain of headache
    2. Patients with hypotension often complain of dizziness
    3. The skin of patients with hypotension can be warm and dry or moist and damp
    4. Patients with a systolic blood pressure less than 100 mm Hg are usually said to be hypotensive
    1. Hyperthyroidism
    2. Myocardial infarction
    3. Gastrointestinal hemorrhage
    4. Vasovagal syncope
    1. Decreased levels of blood adrenaline (epinephrine) and noradrenaline (norepinephrine)
    2. Organ malfunction
    3. Decreased urine output
    4. Circulating substances that depress blood pressure
    1. Intensive tube feeding with a high protein nutritional supplement
    2. Intravenous infusion of noradrenaline (norepinephrine)
    3. Infusion of blood
    4. Urgent surgery

    Author of lecture Arterial Diseases – Hypotension and Shock

     Joseph Alpert, MD

    Joseph Alpert, MD


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