Severe Hypotension

CLINICAL DIAGNOSTIC MANUAL

Severe hypotension is a condition where blood pressure is abnormally low, leading to insufficient perfusion of vital organs. This condition can present acutely or chronically and may be caused by various factors, including cardiac issues, blood volume loss, vascular alterations, and endocrine disorders. Rapid identification and treatment are crucial to prevent serious complications such as shock and organ failure.

Pathology	Suspected Diagnosis	Confirmatory Diagnosis
Low cardiac output	Hypotension, dyspnoea, fatigue, peripheral oedema.	Echocardiogram, blood tests (BNP, troponins).
Decreased circulating volume	Hypotension, tachycardia, pale and cool skin, oliguria.	Complete blood count, electrolytes, abdominal ultrasound, urine analysis.
Loss of vascular tone	Hypotension, tachycardia, signs of shock, warm and moist skin.	Clinical history, autonomic function tests, blood tests.
Addison’s disease	Hypotension, hyperpigmentation, fatigue, weight loss.	Cortisol and ACTH levels, ACTH stimulation test.
Spinal cord injury or disease	Hypotension, loss of motor or sensory control below the level of the injury.	MRI or CT of the spine, neurological examination.