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Symptoms and Signs – Differential Diagnosis of Hypotension
Septicaemia
Hypovolaemia:
Haemorrhage
GI loss
Renal loss (diuretic, diabetes mellitus, diabetes insipidus, post-obstructive
diuresis, acute renal failure
Cutaneous loss (exudative lesions, burns)
Adrenal insufficiency
Cardiovascular:
Any condition that reduced cardiac output, e.g. arrhythmias, reduced diastolic filling
(pericardial disease), myocardial disease, outflow obstruction
Postural hypotension
Volume depletion
Autonomic neuropathy:
Metabolic: diabetes mellitus, amyloidosis (rare}, drugs (tricyclics, L-dopa}
Inflammation: Guillain-Barre syndrome
Infection: HIV, syphilis
Tumours: paraneoplastic (e.g. small cell lung cancer}, hypothalamic
Degenerative: Parkinson's disease, multiple system atrophy, Shy-Drager
Syndrome
Familial dysautonomia (Riley-Day syndrome}
Drugs: Antihypertensives, diuretics, nitrates, antidepressants, sedatives
Leg vein insufficiency
Septicaemia
Hypovolaemia:
Haemorrhage
GI loss
Renal loss (diuretic, diabetes mellitus, diabetes insipidus, post-obstructive
diuresis, acute renal failure
Cutaneous loss (exudative lesions, burns)
Adrenal insufficiency
Cardiovascular:
Any condition that reduced cardiac output, e.g. arrhythmias, reduced diastolic filling
(pericardial disease), myocardial disease, outflow obstruction
Postural hypotension
Volume depletion
Autonomic neuropathy:
Metabolic: diabetes mellitus, amyloidosis (rare}, drugs (tricyclics, L-dopa}
Inflammation: Guillain-Barre syndrome
Infection: HIV, syphilis
Tumours: paraneoplastic (e.g. small cell lung cancer}, hypothalamic
Degenerative: Parkinson's disease, multiple system atrophy, Shy-Drager
Syndrome
Familial dysautonomia (Riley-Day syndrome}
Drugs: Antihypertensives, diuretics, nitrates, antidepressants, sedatives
Leg vein insufficiency
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