UTHSC PA Program Podcast
UTHSC PA Program Podcast
Kristopher Maday, PA-C, DFAAPA
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Cardiovascular - Hypotension
4 minutes Posted May 26, 2026 at 7:34 pm.
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In this episode, we review hypotension, a clinical state of abnormally low blood pressure that can lead to inadequate tissue perfusion and organ dysfunction. We discuss the major underlying mechanisms, including hypovolemia, distributive shock, cardiogenic causes, and obstructive physiology, along with common risk factors such as dehydration, hemorrhage, sepsis, medications, endocrine disorders, and cardiac disease. The episode highlights classic signs and symptoms including dizziness, syncope, weakness, altered mental status, tachycardia, and signs of shock, emphasizing the importance of identifying the underlying cause rather than treating the blood pressure value alone. We also review key components of the diagnostic evaluation, including orthostatic vitals, laboratory studies, EKG, and bedside assessment of perfusion, as well as initial management with fluid resuscitation, vasopressors when indicated, and rapid treatment of the underlying etiology.

References

  1. Bushardt RL, Colomb-Lippa DM, Klinger AM, Reed H. The JAAPA QRS Review for PAs: Study Plan and Guide for PANCE and PANRE. 1st ed. LWW; 2021. ISBN: 9781975143817
  2. Wieling W, Kaufmann H, Claydon V et al. Diagnosis and treatment of orthostatic hypotension. The Lancet Neurology, 21, 735-746
  3. Goldberger, Z, Petek, B, Brignole, M. et al. ACC/AHA/HRS Versus ESC Guidelines for the Diagnosis and Management of Syncope: JACC Guideline Comparison. JACC. 2019 Nov, 74 (19) 2410–2423. https://doi.org/10.1016/j.jacc.2019.09.012
  4. VanWijnen VK, Finucane C, Harms MPM, Nolan H, Freeman RL, Westerhof BE, Kenny RA, terMaaten JC, Wieling W (University Medical Center Groningen, University of Groningen, The Netherlands; St James's Hospital; Lincoln Gate, Trinity College, Dublin, Ireland; Harvard Medical School, Boston, MA, USA; VU University Medical Center; Academic Medical Center, Amsterdam, The Netherlands). Noninvasive beat-to-beat finger arterial pressure monitoring during orthostasis: a comprehensive review of normal and abnormal responses at different ages (Review). J Intern Med2017; 282: 468–483
  5. Kim, M. J., & Farrell, J. (2022). Orthostatic Hypotension: A Practical Approach. American family physician, 105(1), 39–49. 
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