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Doctor insights on: Supine Hypotensive Syndrome

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What is maternal hypotensive syndrome? And does turning patient on left side increase bp, if so, how?

What is maternal hypotensive syndrome? And does turning patient on left side increase bp, if so, how?

Compress vena cava: During pregnancy as uterus gets big and heavy it compresses the inferior vena cava when mother lays on her back. Vena cava is the big vein that drains blood from lower body into the heart. Laying on your left side takes pressure off the vena cava to avoid this compression by the uterus. ...Read more

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Can a patient you may treat who is hypotensive show systolic numbers in the 120-140+ range due to "true" white coat syndrome?

Can a patient you may treat who is hypotensive show systolic numbers in the 120-140+ range due to "true" white coat syndrome?

Hypertension: White coat syndrome or stress induced hypertension can be just as much medical risk as chronic high normal blood pressure. Stage 1 hypertension diagnosis is made at a BP of 140/90 (either number) or higher on 2 or more visits regardless of the "white coat" response. ...Read more

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What to do if i wake up hypotensive & bradycardic!?

What to do if i wake up hypotensive & bradycardic!?

Medicines?: Do you have any symptoms? If you don't, why are you measuring your hr and bp? And what do you call hypotension and bradycardia? Usually both your BP and hr could be lower when waking up. ...Read more

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During a hypotensive crisis how is neostigmine used?

During a hypotensive crisis how is neostigmine used?

Hypotension: neostigmine isn't used in hypotensive crisis, read this: https://books.google.com/books?id=5zd_W_PUwvYC&pg=PA193&lpg=PA193&dq=hypotensive+crisis+and+neostygmine&source=bl&ots=SWufyt2QhL&sig=5vWWEMUYn3pGZ3CDqoR_Gdq3hsM&hl=en&sa=X&ei=tj1aVYuZIcLKogSxyILwCg&ved=0CCAQ6AEwAA#v=onepage&q=hypotensive%20crisis%20and%20neostygmine&f=false ...Read more

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Why is adrenaline contraindicated in hypotensive shock?

Why is adrenaline contraindicated in hypotensive shock?

It's not: But typically you want to volume resuscitate prior to using a pressor like Epinephrine or norepinephrine because that typically fixes the problem. ...Read more

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To restore BP in hypotensive crisis should they give you prostigmin (neostigmine)?

To restore BP in hypotensive crisis should they give you prostigmin (neostigmine)?

Possibly: This may be necessary. To goal is to address the cause of the low blood pressure. For example, if due to acute bleeding, replacement of blood volume is appropriate. If due to vasodilation, vasoconstrictors are helpful. In severe crisis, combinations of treatments are needed. ...Read more

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What leads to cognitive, neuro & endocrine problems after a severe hypotensive event?

What leads to cognitive, neuro & endocrine problems after a severe hypotensive event?

Hypotension: Severe hypotensive episodes often result in ischemic damage or infarction of cells in multiple body organs. The brain, nerves and endocrine cells are all quite sensitive to ischemia. ...Read more

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Was on 15mg lisinopril then 10mg then 5 mg daily then 2.5mg every 12 hr. Took 5mg in morning and was hypotensive 24hr later. Why?

Was on 15mg lisinopril then 10mg then 5 mg daily then 2.5mg every 12 hr. Took 5mg in morning and was hypotensive 24hr later. Why?

You don't need it?: Possibly your blood pressure is not really high any more or you were started on treatment on the basis of only one or two readings. Sometimes, if the heart doesn't pump as forcefully, thyroid level is low, you have lost weight, or other reasons, the blood pressure drops. Being hypotensive can be dangerous (falls, possible strokes, or heart attacks) at your age. Ask your doc if you should stop rx! ...Read more

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How can you restore blood pressure in hypotensive crisis? Prostigmin (neostigmine)?

How can you restore blood pressure in hypotensive crisis? Prostigmin (neostigmine)?

HyPOtensive crisis?: I've never heard of hyPOtensive crisis. HyPERtensive crisis, yes. When someone's blood pressure is dangerously low, that's called "shock." There's hemorrhagic shock & septic shock & shock from low cardiac output due to MI or CHF, etc. Drugs commonly known as pressors such as dopamine, dobutamine, and levarterenol are used to keep BP up. I'll defer to my intensivist colleagues for better answers. ...Read more

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I have an ataxic gait i never had before after a 'hypotensive' episode the doctor said from prloonged dehydration. Will it ever get better?

I have an ataxic gait i never had before after a 'hypotensive' episode the doctor said from prloonged dehydration. Will it ever get better?

Needs evaluation: If you have acquired true ataxia after your blood pressure dropped, you could have injured the cerebellar or brainstem connections due to decreased blood flow. Also, wonder about inner ear issues. Your doctor needs to obtain MRI of brain to check the areas of concern. Physical therapy with gait training could turn this around. ...Read more

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I'm 22 wks pregnant, been having hypotensive fainting spells (70/44 yesterday, 69/37 today). I was told by my MD to eat something salty and push fluids. But I still feel faint. Is it bad for my baby?

I'm 22 wks pregnant, been having hypotensive fainting spells (70/44 yesterday, 69/37 today). I was told by my MD to eat something salty and push fluids. But I still feel faint. Is it bad for my baby?

Be careful: It may be that you have a lower blood pressure, but this should not put your baby at risk. An accident, such as falling, would be bad. Try the fluids and be careful! ...Read more

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My BP has been getting lower. Used to be pre-hypertensive, now it's almost always borderline hypotensive? Dizzy when I stand. I'm bedridden with CFS.

My BP has been getting lower. Used to be pre-hypertensive, now it's almost always borderline hypotensive? Dizzy when I stand. I'm bedridden with CFS.

Orthostasis: when your BP drops when moving from a supine to a standing position is quite common with the use of antihypertensive medications. I suggest calling your physician and titrating your medications. ...Read more

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(1) Is bisoprolol used to treat atrial fibrillation? (2) If a person becomes hypotensive e.g.102/55, 102/68, & 106/63 should he stop using bisoprolol?

(1) Is bisoprolol used to treat atrial fibrillation? (2) If a person becomes hypotensive e.g.102/55, 102/68, & 106/63 should he stop using bisoprolol?

Yes: This beta blocker is used to treat or control the ventricular response to atrial fibrillation. It can lower blood pressure and, of course, slow the ventricular rate too much(below 60). If you're experiencing side effects, discuss this with your physician or cardiologist who may lower the dose of prescribe another beta blocker or even switch to digoxin although this medication is less popular now. ...Read more

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If you become hypotensive from dehydration with all the symptoms but don't faint, could this cause brain damage?

If you become hypotensive from dehydration with all the symptoms but don't faint, could this cause brain damage?

No: As long as you are fully conscious and thinking normally no brain damage. Even fainting due to dehydration is unlikely to cause brain damage in a healthy person. However, getting that dehydrated can cause other problems and should be avoided. If your question is related to athletic activities outdoor activities dehydration should never occurred. Plan ahead to keep hydrated! ...Read more

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What is best drug to treat BP of 214 from normal saline infusion in ambulance? Was hypotensive 92 yo who was dry; salt sensitive mild htn, prior cva.

What is best drug to treat BP of 214 from normal saline infusion in ambulance?  Was hypotensive 92 yo who was dry; salt sensitive mild htn, prior cva.

Confused by question: Someone w/ low blood pressure en route to hospital by ambulance doesn't suddenly have increase in BP to 214 due to saline infusion. Increase may be a reflection of underlying illness which necessitated transfer to hospital or anxiety about ride to hospital or fear of illness or other injectable meds received to raise low bp. Treatment meds & parameters then depend on underlying acute illness. ...Read more

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What do labored breathing with yawning mean? Is either associated with vasovagal or hypotensive event? What about pallor?

What do labored breathing with yawning mean? Is either associated with vasovagal or hypotensive event? What about pallor?

Yes, & yes, & yes: You are precisely right. Has your blood pressure and heart rate been monitored lately? Are you on medications which nauseate you? Are you on medications which lower your blood pressure? People's ability to tolerate drugs deteriorates progressively as they age, especially when on multiple medications. ...Read more

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What is best way to evacuate the bowel once focal ileus has been diagnosed and pt has become nauseous, vomits bile, dehydrated, hypotensive,?

What is best way to evacuate the bowel once focal ileus has been diagnosed and pt has become nauseous, vomits bile, dehydrated, hypotensive,?

Resuscitation: If the patient is hypotensive, the ileus becomes secondary. Nasogastric tube will be helpful in decompressing the bowel proximal to the ileus or obstruction, but the dehydration and hypotension is more important at this point. ...Read more