Cardiogenic Shock (see Cardiogenic Shock)

Arrhythmia/Conduction Disturbance

• Bradyarrhythmia
  • Second Degree Atrioventricular Block-Mobitz Type II (Second Degree Heart Block-Mobitz Type II) (see Second Degree Atrioventricular Block-Mobitz Type II)
  • Sinus Bradycardia (see Sinus Bradycardia)
  • Third Degree Atrioventricular Block (Third Degree Heart Block, Complete Heart Block) (see Third Degree Atrioventricular Block
• Tachyarrythmia
  • Atrial Fibrillation (see Atrial Fibrillation)
  • Atrial Flutter (see Atrial Flutter)
  • Supraventricular Tachycardia (SVT) (see Supraventricular Tachycardia)
  • Ventricular Fibrillation (see Ventricular Fibrillation)
  • Ventricular Tachycardia (VT) (see Ventricular Tachycardia)

Cardiomyopathy (see Congestive Heart Failure)

• Primary Cardiomyopathies (Predominantly Involving the Heart)
  • Genetic
    • Arrhythmogenic Right Ventricular Cardiomyopathy (Arrhythmogenic Right Ventricular Dysplasia) (see Arrhythmogenic Right Ventricular Cardiomyopathy)
    • Conduction System Disease
      • Lenegre Disease
      • Sick Sinus Syndrome
    • Glycogen Storage Diseases
      • Danon
      • PRKAG2
    • Hypertrophic Cardiomyopathy
    • Ion Channelopathies
      • Brugada Syndrome
      • Catecholaminergic Polymorphic Ventricular Tachycardia
      • Idiopathic Ventricular Fibrillation
      • Long-QT Syndrome
      • Short-QT Syndrome
    • Left Ventricular Noncompaction
    • Mitochondrial Myopathies
  • Mixed (Predominantly Non-Genetic; Familial Disease with a Genetic Origin has been Reported in a Minority of Cases)
    • Dilated Cardiomyopathy: this is a heterogeneous group of disorders characaterized by ventricular dilation and decreased myocardial contractility in the absence of abnormal loading (valvular heart disease, hypertension)
    • Restrictive Cardiomyopathy (Non-Dilated and Non-Hypertrophied)
  • Acquired
    • Cardiomyopathy in Infants of Insulin-Dependent Diabetic Mothers
    • Myocarditis (Inflammatory Cardiomyopathy) (see Myocarditis)
    • Peripartum Cardiomyopathy
    • Tachycardia-Induced Cardiomyopathy
    • Takotsubo Cardiomyopathy (Stress Cardiomyopathy) (see Takotsubo Cardiomyopathy)
• Secondary Cardiomyopathies
  • Cardiofacial
    • Lentiginosis
    • Noonan Syndrome
  • Endocrine/Metabolic
    • Acidosis (see Metabolic Acidosis-General)
    • Acromegaly (see Acromegaly)
    • Diabetes Mellitus (see Diabetes Mellitus)
    • Growth Hormone Deficiency: growth hormone and insulin-like growth factor 1 and required for cardiac development
    • Hyperparathyroidism (see Hyperparathyroidism)
    • Hyperthyroidism (see Hyperthyroidism)
    • Hypocalcemia (see Hypocalcemia)
    • Hypokalemia (see Hypokalemia)
    • Hypophosphatemia (see Hypophosphatemia)
    • Hypothyroidism (see Hypothyroidism)
    • Hypoxia (see Hypoxemia)
    • Obesity (see Obesity)
    • Pheochromocytoma (see Pheochromocytoma)
  • Endomyocardial
    • Endomyocardial Fibrosis
    • Hypereosinophilic Syndrome (Löeffler’s Endocarditis????) (see Hypereosinophilic Syndrome)
  • Hematologic Disease
    • Sickle Cell Disease (see Sickle Cell Disease)
    • Anemia (see Anemia)
    • Henoch-Schonlein Purpura (see Henoch-Schonlein Purpura)
  • Infiltrative (Accumulation of Abnormal Substances in Extracellular Space Between Myocytes)
    • Amyloidosis (see Amyloidosis)
    • Gaucher’s Disease
    • Hunter’s Syndrome
    • Hurler’s Syndrome
  • Infectious/Inflammatory
    • Hantavirus Cardiopulmonary Syndrome (see Hantavirus Cardiopulmonary Syndrome): unusually produces sepsis with a low CO and high SVR physiology
      • Hantavirus Genus: Sin Nombre Virus (SNV) is the most commonly associated Hantavirus in the US
    • Hemorrhagic Fever with Renal Syndrome (HFRS) (see Hemorrhagic Fever with Renal Syndrome)
      • Hantavirus Genus: Hantaan Virus, Dobrova Virus, Seoul Virus (Baltimore Rat Virus)
    • Sarcoidosis (see Sarcoidosis)
    • Sepsis-Induced Myocardial Depression (see Sepsis)
  • Ischemic
    • Acute Myocardial Infarction (MI) (see Coronary Artery Disease)
      • Physiology: involving >40% of left ventricular myocardium or right ventricular infarction
    • Myocardial Ischemia
    • Stunned Myocardium (from Prolonged Ischemia)
      • Cardiac Arrest (see Cardiac Arrest)
      • Post-Cardiopulmonary Bypass (CPB) (see Cardiopulmonary Bypass)
      • Prolonged Hypotension
  • Neoplasm
    • Leukemia
    • Multiple Myeloma (see Multiple Myeloma)
  • Neuromuscular/Neurologic
    • Becker Muscular Dystrophy (see Becker Muscular Dystrophy)
    • Chronic Progressive External Opthmoplegia (Kearns-Savre)
    • Duchenne Muscular Dystrophy (see Duchenne Muscular Dystrophy)
    • Emery-Dreifuss Muscular Dystrophy
    • Familial Centronuclear Myopathy
    • Fascioscapulohumeral Dystrophy (Landouzy-Dejerine)
    • Friedrich’s Ataxia
    • Humuloperitoneal Ataxia
    • Juvenile Progressive Spinal Muscular Atrophy (Kugelberg-Welander)
    • Limb-Girdle Muscular Dystrophy
    • Myotonia Atrophica (Steinert)
    • Myotonic Dystrophy
    • Neurofibromatosis (see Neurofibromatosis)
    • Tuberous Sclerosis (see Tuberous Sclerosis)
  • Nutritional
    • Carnitine Deficiency (see Carnitine)
    • Keshan’s Disease
    • Kwashiorkor
    • Niacin Deficiency (Pellagra) (see Niacin)
    • Selenium Deficiency (see Selenium)
    • Thiamine Deficiency (Beriberi) (see Thiamine)
    • Vitamin C Deficiency (Scurvy) (see Vitamin C
  • Rheumatologic
    • Behcet’s Disease (see Behcet’s Disease)
    • Eosinophilic Granulomatosis with Angiitis (EGPA, Churg-Strauss Syndrome) (see Eosinophilic Granulomatosis with Polyangiitis)
    • Granulomatosis with Polyangiitis (GPA, Wegener’s Granulomatosis) (see Granulomatosis with Polyangiitis)
    • Microscopic Polyangiitis (see Microscopic Polyangiitis)
    • Polyarteritis Nodosa (PAN) (see Polyarteritis Nodosa)
    • Polydermatomyositis (see Polydermatomyositis)
    • Rheumatoid Arthritis (RA) (see Rheumatoid Arthritis)
    • Scleroderma (see Scleroderma)
    • Systemic Lupus Erythematosus (SLE) (see Systemic Lupus Erythematosus)
  • Storage (Accumulation of Abnormal Substances Intracellularly Within Myocytes)
    • Fabry’s Disease
    • Hemochromatosis (see Hemochromatosis)
    • Niemann-Pick Disease
    • Ochronosis
    • Oxalosis (see Primary Hyperoxaluria)
    • Pompe’s Disease
  • Traumatic
    • Cardiac Contusion (see Cardiac Contusion)
  • Drug/Toxin
    • 5-Fluorouracil (5-FU) (see 5-Fluorouracil)
    • Amiodarone (see Amiodarone)
      • Pharmacology: negative inotropy can occur in patients with preexisting left ventricular dysfunction with EF <35% (amiodarone also casuses peripheral vasodilation, which may offset some of the negative inotropy)
    • Amphetamine (see Amphetamine)
    • Anabolic Steroids (see xxxx)
    • Antimalarials
      • Chloroquine (Aralen) (see Chloroquine)
      • Hydrochloroquine (Plaquenil) (see Hydroxychloroquine)
    • Antimony (see Antimony)
    • Antracyclines
      • Daunorubicin (Daunomycin, Cerubidine) (see Daunorubicin)
      • Doxorubicin (Adriamycin) (see Doxorubicin)
    • Arsenic (see Arsenic)
    • β-Blocker Intoxication (see β-Adrenergic Receptor Antagonists)
      • Pharmacology: negative inotropy may particularly occur in the setting of intoxication
    • Calcium Channel Blocker Intoxication (see Calcium Channel Blockers)
      • Pharmacology: negative inotropy may particularly occur in the setting of intoxication
    • Carboxyhemoglobinemia (see Carboxyhemoglobinemia)
    • Carbon Tetrachloride (see Carbon Tetrachloride)
    • Catecholamines
    • Clozapine (Clozaril) (see Clozapine)
    • Cobalt (see Cobalt)
    • Cocaine (see Cocaine)
    • Cyclophosphamide (Cytoxan) (see Cyclophosphamide)
    • Emetine(see Emetine)
    • Ephedra (see Ephedra)
    • Ethanol (see Ethanol)
    • Interferons (see Interferons)
    • Lead (see Lead)
    • Lithium (see Lithium)
    • Mercury (see Mercury)
    • Methamphetamine (see Methamphetamine)
      • Acute Methamphetamine Intoxication
      • Chronic Methamphetamine Abuse
    • Methylphenidate (Ritalin) (see Methylphenidate)
    • Methysergide (see Methysergide)
    • Mitomycin-C (see Mitomycin)
    • Phenothiazines (se Phenothiazines)
    • Propofol Infusion Syndrome (see Propofol)
    • Taxol Derivatives (see Taxanes)
      • Docetaxel (Taxotere) (see Docetaxel)
      • Paclitaxel (Taxol) (see Paclitaxel)
    • Trastuzumab (Herceptin) (see Trastuzumab)
    • Tricyclic Antidepressants (see Tricyclic Antidepressants)
    • White Phosphorus Toxicity (see White White Phosphorus)
    • Widow Spider Bite (see Widow Spider Bite): cardiomyopathy occurs rarely
    • Zidovudine (Retrovir) (see Zidovudine)
  • Other
    • Radiation Therapy (see Radiation Therapy)
    • Stiff Left Atrial Syndrome Following Left Atrial Catheter Ablation (see Stiff Left Atrial Syndrome)
      • Epidemiology
      • Physiology

Increased Afterload

• Aortic Coarctation (see Aortic Coarctation)
• Hypertrophic Obstructive Cardiomyopathy (HOCM) (see Hypertrophic Cardiomyopathy)
• Malignant Hypertension (see Hypertension)
• Severe Aortic Stenosis (see Aortic Stenosis)

Increased Intrathoracic Pressure (with Impaired Right-Sided Venous Return)

• Herniation of Abdominal Viscera Into Thorax
• Positive-Pressure Ventilation with High Airway Pressures (see Acute Respiratory Distress Syndrome, [[Acute Respiratory Distress Syndrome]])
• Tension Pneumothorax (see Pneumothorax, [[Pneumothorax]])

Intracardiac Shunt (see Intracardiac and Extracardiac Shunt, [[Intracardiac and Extracardiac Shunt]])

• Atrial Septal Defect (ASD) (see Atrial Septal Defect, [[Atrial Septal Defect]])
• Ruptured Sinus of Valsalva Aneurysm (see Sinus of Valsalva Aneurysm, [[Sinus of Valsalva Aneurysm]])
• Ventricular Septal Defect (VSD) (see Ventricular Septal Defect, [[Ventricular Septal Defect]])
• Ventricular Septal Rupture (see Ventricular Septal Rupture, [[Ventricular Septal Rupture]])

Valvular Disease/Mechanical Disturbance

• Aortic Insufficiency (AI) (see Aortic Insufficiency, [[Aortic Insufficiency]])
• Aortic Stenosis (AS) (see Aortic Stenosis, [[Aortic Stenosis]])
• Atrial Myxoma (see Atrial Myxoma, [[Atrial Myxoma]])
• Atrial Thrombus (see Intracardiac Thrombus, [[Intracardiac Thrombus]])
• Constrictive Pericarditis (see Constrictive Pericarditis, [[Constrictive Pericarditis]])
  • Physiology: xxxx
• Mitral Regurgitation (MR) (see Mitral Regurgitation, [[Mitral Regurgitation]])
• Mitral Stenosis (see Mitral Stenosis, [[Mitral Stenosis]])
• Papillary Muscle Dysfunction/Rupture
• Pulmonic Stenosis (see Pulmonic Stenosis, [[Pulmonic Stenosis]])
  • Physiology: xxx
• Ruptured Left Ventricular Aneurysm (see Left Ventricular Aneurysm, [[Left Ventricular Aneurysm]])
• Ruptured Sinus of Valsalva Aneurysm (see Sinus of Valsalva Aneurysm, [[Sinus of Valsalva Aneurysm]])
• Tamponade (see Tamponade, [[Tamponade]])
  • Physiology: produces diastolic dysfunction
• Tricuspid Regurgitation (TR) (see Tricuspid Regurgitation, [[Tricuspid Regurgitation]])
• Tricuspid Stenosis (see Tricuspid Stenosis, [[Tricuspid Stenosis]])
  • Physiology: xxx
• Ventricular Septal Defect (VSD) (see Ventricular Septal Defect, [[Ventricular Septal Defect]])

Distributive Shock (Vasodilatory Shock)

Anaphylaxis/Anaphylactic Shock

• Anaphylaxis (see Anaphylaxis, [[Anaphylaxis]])
  • Physiology: peripheral vasodilation (due to histamine and other vasoactive substances)

Infection

• Anaplasmosis Sepsis-Like or Toxic Shock-Like Syndrome (see Anaplasmosis, [[Anaplasmosis]])
• Ehrlichiosis Sepsis-Like or Toxic Shock-Like Syndrome (see Ehrlichiosis, [[Ehrlichiosis]])
• Sepsis/Septic Shock (see Sepsis, [[Sepsis]])
  • Epidemiology: sepsis is the most common type of distributive shock
  • Physiology: third-spacing of fluids (with decreased intravascular volume) and peripheral vasodilation
• Toxic Shock Syndrome (TSS)
  • Types
    • Staphylococcal Toxic Shock Syndrome (see Staphylococcal Toxic Shock Syndrome, [[Staphylococcal Toxic Shock Syndrome]])
    • Streptococcal Toxic Shock Syndrome (see Streptococcal Toxic Shock Syndrome, [[Streptococcal Toxic Shock Syndrome]])
  • Physiology: peripheral vasodilation

Systemic Inflammatory Response Syndrome (SIRS) (see Sepsis, [[Sepsis]])

• Acute Pancreatitis (see Acute Pancreatitis, [[Acute Pancreatitis]])
  • Physiology: third-spacing of fluids (with decreased intravascular volume) and peripheral vasodilation
• Air Embolism (see Air Embolism, [[Air Embolism]])
  • Physiology
    • XXX
• Amniotic Fluid Embolism (see Amniotic Fluid Embolism, [[Amniotic Fluid Embolism]])
• Burns (see Burns, [[Burns]])
• Crush Injury
• Fat Embolism (see Fat Embolism, [[Fat Embolism]])
• Idiopathic Systemic Capillary Leak Syndrome (see Idiopathic Systemic Capillary Leak Syndrome, [[Idiopathic Systemic Capillary Leak Syndrome]])
• Post-Cardiac Arrest with Return of Spontaneous Circulation (see Cardiac Arrest, [[Cardiac Arrest]])
• Trauma (see Trauma-General, [[Trauma-General]])

Endocrine/Metabolic/Nutritional Deficiency-Associated Hypotension

• Acidemia
  • Metabolic Acidosis-Elevated Anion Gap (see Metabolic Acidosis-Elevated Anion Gap, [[Metabolic Acidosis-Elevated Anion Gap]])
    • Physiology: XXX
  • Metabolic Acidosis-Normal Anion Gap (see Metabolic Acidosis-Normal Anion Gap, [[Metabolic Acidosis-Normal Anion Gap]])
    • Physiology: XXX
• Adrenal Insufficiency (see Adrenal Insufficiency, [[Adrenal Insufficiency]])
  • Physiology: peripheral vasodilation
• Hyperthyroidism (see Hyperthyroidism, [[Hyperthyroidism]])
  • Physiology:
• Hypothyroidism/Myxedema (see Hypothyroidism, [[Hypothyroidism]])
  • Physiology: peripheral vasodilation
• Pheochromocytoma (see Pheochromocytoma, [[Pheochromocytoma]])
  • Epidemiology: occurs in some cases
  • Clinical Patterns
    • Episodic Hypotension: in rare cases where the tumor secretes only epinephrine
    • Pattern of Rapid Cyclic Fluctuation Between Hypertension and Hypotension (Cycling Every 7-15 min): unclear mechanism
    • Orthostatic Hypotension: due predominantly to decreased plasma volume
• Thiamine Deficiency (Beriberi) (see Thiamine, [[Thiamine]])
  • Physiology: peripheral vasodilation

Hematologic Disease-Associated Hypotension

• Acute Graft vs Host Disease (see Graft vs Host Disease, [[Graft vs Host Disease]])
• Acute Hemolytic Transfusion Reaction (see Acute Hemolytic Transfusion Reaction, [[Acute Hemolytic Transfusion Reaction]])
• Severe Chronic Anemia (see Anemia, [[Anemia]])
  • Physiology: XXXX

Neurogenic Shock (see Neurogenic Shock, [[Neurogenic Shock]])

• Acute Spinal Cord Injury (SCI) (see Acute Spinal Cord Injury, [[Acute Spinal Cord Injury]])
  • Physiology
    • Interruption of Autonomic Pathways, Resulting in Decreased Systemic Vascular Resistance and Altered Vagal Tone: probably the predominant mechanism
    • Myocardial Depression: may also play a role
• Neuraxial Anesthesia (see xxxx, [[xxxx]])
  • Physiology: xxxx
• Traumatic Brain Injury (TBI) (see Traumatic Brain Injury, [[Traumatic Brain Injury]])
  • Physiology: xxxx

Drug/Toxin-Associated Hypotension

• Abacavir-Hypersensitivity Reaction (see Abacavir, [[Abacavir]])
  • Pharmacology: peripheral vasodilation
• Alcohol Intoxications
  • Ethanol* (see Ethanol, [[Ethanol]])
    • Pharmacology: peripheral vasodilation
  • Ethylene Glycol Intoxication (see Ethylene Glycol, [[Ethylene Glycol]])
    • Pharmacology: peripheral vasodilation
  • Isopropanol Intoxication (see Isopropanol, [[Isopropanol]])
    • Pharmacology: peripheral vasodilation
  • Methanol Intoxication (see Methanol, [[Methanol]])
    • Pharmacology: peripheral vasodilation
• All-Trans Retinoic Acid (ATRA)/Retinoic Acid Syndrome (see All-Trans Retinoic Acid, [[All-Trans Retinoic Acid]])
  • Pharmacology: peripheral vasodilation
• Amiodarone (see Amiodarone, [[Amiodarone]])
  • Pharmacology: peripheral vasodilation (note: negative inotropy can also occur in patients with preexisting left ventricular dysfunction with EF <35%)
• Benzodiazepines (see Benzodiazepines, [[Benzodiazepines]])
  • Pharmacology: peripheral vasodilation
• Capsaicin (see Capsaicin, [[Capsaicin]])
  • Pharmacology: peripheral vasodilation
• Cholinergic Intoxication (see Cholinergic Intoxication, [[Cholinergic Intoxication]])
  • Carbamate Intoxication (see Carbamates, [[Carbamates]])
  • Organophosphate Intoxication (see Organophosphates, [[Organophosphates]])
• Cigua Toxin Poisoning (see Cigua Toxin Poisoning, [[Cigua Toxin Poisoning]])
  • Physiology: dysfunction of calcium and sodium channels, resulting in peripheral vasodilation
• Cyanide Intoxication (see Cyanide, [[Cyanide]])
  • Pharmacology: mitochondrial dysfunction
  • Clinical: hypotension occurs late in the course
• Cytokine Release Syndrome (see Cytokine Release Syndrome, [[Cytokine Release Syndrome]])
  • Pharmacology: peripheral vasodilation
• Dexmedetomidine (Precedex) (see Dexmedetomidine, [[Dexmedetomidine]])
  • Pharmacology: peripheral vasodilation
• Dobutamine (Dobutrex) (see Dobutamine, [[Dobutamine]])
  • Pharmacology: myocardial β1-adrenergic receptor agonist (chronotropic/inotropic effects) and vascular β2-adrenergic/α1-adrenergic receptor agonist (if vascular β2-adrenergic effects exceed α1-adrenergic receptor agonist effects, some peripheral vasodilation may occur)
• Endothelin Receptor Antagonists (ERA’s) (see Endothelin Receptor Antagonists, [[Endothelin Receptor Antagonists]])
  • Pharmacology: peripheral vasodilation
• Envenomations
  • Types
    • Scorpion Sting (see Scorpion Sting, [[Scorpion Sting]])
    • Rattlesnake Bit (see Rattlesnake Bite, [[Rattlesnake Bite]])
    • Widow Spider Bite (see Widow Spider Bite, [[Widow Spider Bite]])
      • Epidemiology: hypertension is more characteristically seen in widow spider bites, hypotension occurs rarely
• Estrogen (see Estrogen, [[Estrogen]])
  • Pharmacology: peripheral vasodilation
• Glyphosate Ingestion (see Glyphosate, [[Glyphosate]])
  • Pharmacology: peripheral vasodilation
• Hemoglobinopathies
  • Carboxyhemoglobinemia (see Carboxyhemoglobinemia, [[Carboxyhemoglobinemia]])
    • Pharmacology: mitochondrial dysfunction
  • Methemoglobinemia (see Methemoglobinemia, [[Methemoglobinemia]])
    • Physiology: peripheral vasodilation
• Hexoprenaline (Gynipral) (see Hexoprenaline, [[Hexoprenaline]])
  • Pharmacology: β2-adrenergic receptor agonist
• Hydrogen Sulfide Gas Inhalation (see Hydrogen Sulfide Gas, [[Hydrogen Sulfide Gas]])
• Intravenous Immunoglobulin (IVIG) (see Intravenous Immunoglobulin, [[Intravenous Immunoglobulin]])
• L-Arginine (see L-Arginine, [[L-Arginine]])
  • Pharmacology: nitric oxide induction, resulting in peripheral vasodilation
• Magnesium Sulfate (see Magnesium Sulfate, [[Magnesium Sulfate]])
  • Epidemiology: with rapid infusion
• Metal Intoxications
  • Agents
    • Arsenic Intoxication (see Arsenic, [[Arsenic]])
    • Iron Intoxication (see Iron, [[Iron]])
    • Manganese Intoxication (see Manganese, [[Manganese]])
    • Selenium Intoxication (see Selenium, [[Selenium]])
    • Thallium Intoxication (see Thallium, [[Thallium]])
  • Pharmacology: peripheral vasodilation
• N-Acetylcysteine (Mucomyst, Acetadote, Fluimucil, Parvolex) (see N-Acetylcysteine, [[N-Acetylcysteine]])
  • Epidemiology: associated with oral administration
  • Pharmacology: peripheral vasodilation
• Nerium Oleander Intoxication (see Nerium Oleander, [[Nerium Oleander]])
• Neuroleptic Malignant Syndrome (NMS) (see Neuroleptic Malignant Syndrome, [[Neuroleptic Malignant Syndrome]])
  • Physiology: autonomic instability
• Nitrites and Nitrates (see Nitrites and Nitrates, [[Nitrites and Nitrates]])
  • Pharmacology: nitric oxide induction, resulting in peripheral vasodilation
• Ocrelizumab (Ocrevus) (see Ocrelizumab, [[Ocrelizumab]])
  • Epidemiology: may occur as a component of infusion reaction
• Opiates (see Opiates, [[Opiates]])
  • Pharmacology: peripheral vasodilation
• Papaverine (see Papaverine, [[Papaverine]])
  • Pharmacology: peripheral vasodilation
• Phenytoin (Dilantin/)Fosphenytoin (Cerebyx) (see Fosphenytoin, [[Fosphenytoin]] and (see Phenytoin, [[Phenytoin]])
  • Pharmacology: peripheral vasodilation
• Phosphodiesterase Type 5 (PDE5) Inhibitors (see Phosphodiesterase Type 5 Inhibitors, [[Phosphodiesterase Type 5 Inhibitors]])
  • Pharmacology: inhibits phosphodiesterase 5/PDE5 (the enzyme which degrades cGMP), resulting in enhanced NO-mediated smooth muscle relaxation and therefore, peripheral vasodilation
• Propofol (Diprivan) (see Propofol, [[Propofol]])
  • Pharmacology: peripheral vasodilation
• Prostaglandins with Vasodilatory Properties
  • Agents
    • Epoprostenol (PGI2, Prostacyclin, Flolan, Veletri) (see Epoprostenol, [[Epoprostenol]])
    • Iloprost (Ilomedin, Ventavis) (see Iloprost, [[Iloprost]])
    • Prostaglandin E1 (Alprostadil) (see Prostaglandin E1, [[Prostaglandin E1]])
  • Pharmacology: peripheral vasodilation
• Protamine (see Protamine, [[Protamine]])
  • Pharmacology: peripheral vasodilation
• Rasburicase (Elitek) (see Rasburicase, [[Rasburicase]])
  • Pharmacology: peripheral vasodilation
• Ruxolitinib (Jakafi) Withdrawal Syndrome (see Ruxolitinib, [[Ruxolitinib]])
  • Epidemiology: occurs 1 day-3 wks after drug withdrawal
• Salicylate Intoxication (see Acetylsalicylic Acid, [[Acetylsalicylic Acid]])
  • Pharmacology: peripheral vasodilation
  • Clinical : pseudosepsis with fever, tachypnea, metabolic acidosis, and hypotension
• Scombroid (see Scombroid, [[Scombroid]])
  • Pharmacology: peripheral vasodilation
• Serotonin Syndrome (see Serotonin Syndrome, [[Serotonin Syndrome]])
  • Pharmacology: peripheral vasodilation
• Sevelamer (Renagel, Renvela) (see Sevelamer, [[Sevelamer]])
• Tetrahydrocannabinol (THC) (see Tetrahydrocannabinol, [[Tetrahydrocannabinol]])
  • Pharmacology: peripheral vasodilation
• Tetrodotoxin
  • Epidemiology: associated with ingestion of tetrodotoxin-contaminated pufferfish
  • Physiology: tetrodotoxin inhibits sodium channels on vascular smooth muscle
• Theobromine (see Theobromine, [[Theobromine]])
  • Pharmacology: peripheral vasodilation
• Thrombolytics (see Thrombolytics, [[Thrombolytics]])
• Transfusion-Associated Acute Lung Injury (TRALI) (see Transfusion-Associated Acute Lung Injury, [[Transfusion-Associated Acute Lung Injury]])
• Tricyclic Antidepressant Intoxication (see Tricyclic Antidepressants, [[Tricyclic Antidepressants]])
  • Pharmacology: peripheral vasodilation
• Vancomycin-Associated Red Man Syndrome (see Vancomycin, [[Vancomycin]])
  • Pharmacology: peripheral vasodilation
• Vasodilator Antihypertensives
  • Agents
    • α-Adrenergic Receptor Antagonists (see α-Adrenergic Receptor Antagonists, [[α-Adrenergic Receptor Antagonists]])
      • Pharmacology: α2-adrenergic receptor antagonism, resulting peripheral vasodilation
    • α-Methyldopa (Aldomet, Aldoril, Dopamet, Dopegyt) (see α-Methyldopa, [[α-Methyldopa]])
      • Pharmacology: α2-adrenergic receptor agonist, resulting in peripheral vasodilation
    • Angiotensin Converting Enzyme (ACE) Inhibitors (see Angiotensin Converting Enzyme (ACE) Inhibitors, [[Angiotensin Converting Enzyme Inhibitors]])
      • Pharmacology: angiotensin converting enzyme inhibition, resulting in peripheral vasodilation
    • Angiotensin II Receptor Blockers (ARB) (see Angiotensin II Receptor Blockers, [[Angiotensin II Receptor Blockers]])
      • Pharmacology: angiotensin II receptor inhibition, resulting in peripheral vasodilation
    • β-Adrenergic Receptor Antagonists (β-Blockers) (see β-Adrenergic Receptor Antagonists, [[β-Adrenergic Receptor Antagonists]])
      • Pharmacology: β-adrenergic receptor antagonism, resulting in decreased cardiac output and peripheral vasodilation
    • Calcium Channel Blockers (see Calcium Channel Blockers, [[Calcium Channel Blockers]])
      • Pharmacology: calcium channel antagonism, resulting in peripheral vasodilation (and additionally decreased cardiac output with some of the agents)
    • Clonidine (Catapres, Kapvay, Nexiclon) (see Clonidine, [[Clonidine]])
      • Pharmacology: α2-adrenergic receptor agonism, resulting in peripheral vasodilation
    • Hydralazine (see Hydralazine, [[Hydralazine]])
      • Pharmacology: peripheral vasodilation
    • Minoxidil (see Minoxidil, [[Minoxidil]])
      • Pharmacology: direct relaxation of arteriolar smooth muscle (possibly mediated by cAMP), resulting in peripheral vasodilation

Other

• Cirrhosis/End-Stage Liver Disease (see Cirrhosis, [[Cirrhosis]])
  • Physiology: characteristically produces a high cardiac output (CO)/low systemic vascular resistance (SVR) state
• Hepatic Veno-Occlusive Disease (see Hepatic Veno-Occlusive Disease, [[Hepatic Veno-Occlusive Disease]])
• Pregnancy (see Pregnancy, [[Pregnancy]])
  • Physiology: pregnancy increases plasma volume, increases cardiac output, increases stroke volume, increases heart rate, decreases blood pressure, and decreases SVR
• Purpura Fulminans (see Purpura Fulminans, [[Purpura Fulminans]])
• Systemic Arteriovenous Fistula (see Systemic Arteriovenous Fistula, [[Systemic Arteriovenous Fistula]])
  • Types
    • Femoral Arteriovenous Fistula: most common type of acquired arteriovenous fistula (due to the frequency of using the femoral site for percutaneous arterial or venous access)
    • Hemodialysis Arteriovenous Fistula (see Hemodialysis Arteriovenous Fistula, [[Hemodialysis Arteriovenous Fistula]])
  • Clinical: high output heart failure may occur
• Systemic Mastocytosis (see Systemic Mastocytosis)
  • Physiology: peripheral vasodilation
• Vasoplegic Syndrome (Post-Cardiac Surgery Vasodilation) (see Vasoplegic Syndrome)
  • Physiology: peripheral vasodilation following cardiac surgery
• Vasovagal Syncope (see Vasovagal Syncope)
  • Physiology: peripheral vasodilation

Hemorrhagic Shock (see Hemorrhagic Shock)

Gastrointestinal Hemorrhage (see Gastrointestinal Hemorrhage, [[Gastrointestinal Hemorrhage]])

• Lower Gastrointestinal Hemorrhage (see Gastrointestinal Hemorrhage)
• Upper Gastrointestinal Hemorrhage (see Gastrointestinal Hemorrhage)

Hemoperitoneum (see Hemoperitoneum)

• Various Etiologies

Intramuscular Hemorrhage (Into Thigh)

• Various Etiologies

Intraoperative/Postoperative Hemorrhage

• Various Etiologies

Retroperitoneal Hemorrhage (see Retroperitoneal Hemorrhage)

• Ruptured Abdominal Aortic Aneurysm (AAA) (see Abdominal Aortic Aneurysm)
• Other Etiologies

Severe Hemolysis (see Hemolytic Anemia)

• Sickle Cell Crisis (see Sickle Cell Disease)

Trauma with External Hemorrhage

• Motor Vehicle Accident (MVA)
• Traumatic Fall/Assault

Uterine/Vaginal Hemorrhage

• Post-Partum Hemorrhage
• Uterine Tumor
• Vaginal Laceration

Other

• Ruptured Left Ventricular Aneurysm (see Left Ventricular Aneurysm)

Hypovolemic Shock (see Hypovolemic Shock)

Dermal Fluid Loss

• Altered Mental Status with Inadequate Fluid Intake
  • Intoxication
• Burns (see Burns)
• Diaphoresis (see Diaphoresis)
• Heat Stroke/Environmental Exposure (see Heat Stroke)

Gastrointestinal Fluid Loss

• Diarrhea (see Diarrhea)
• Early Dumping Syndrome (After Gastric Bypass) (see Dumping Syndrome and Gastric Bypass)
  • Physiology: hyperosmolality of food causes rapid fluid shift from the plasma into the bowel
• External Drainage
• Vomiting (see Nausea and Vomiting)

Renal Fluid Loss

• Excessive Diuresis
• Hypoaldosteronism (see Hypoaldosteronism)
  • Epidemiology: although aldosterone normally acts to increase sodium retention, hypoaldosteronism is not usually associated with significant sodium wasting (except in young children)
    • This is due to the compensatory action of other sodium-retaining stimuli (such as angiotensin II and norepinephrine)
• Pheochromocytoma (see Pheochromocytoma)
  • Epidemiology: occurs in some cases
  • Clinical Patterns
    • Episodic Hypotension: in rare cases where the tumor secretes only epinephrine
    • Pattern of Rapid Cyclic Fluctuation Between Hypertension and Hypotension (Cycling Every 7-15 min): unclear mechanism
    • Orthostatic Hypotension: due predominantly to decreased plasma volume
• Salt-Wasting Nephropathy

Third-Space Fluid Loss

• Acute Pancreatitis (see Acute Pancreatitis)
• Cirhosis (see Cirrhosis)
• Crush Injury
• Intestinal Obstruction
  • Colonic Obstruction (see Colonic Obstruction)
  • Small Bowel Obstruction (SBO) (see Small Bowel Obstruction)
• Post-Operative Intraabdominal Fluid Loss
• Trauma

Obstructive Shock

Mechanical

• Abdominal Compartment Syndrome (see Abdominal Compartment Syndrome)
  • Physiology: xxxx
• Aortocaval Compression (Due to Positioning or Surgical Retraction)
  • Physiology: xxxx
• Constrictive Pericarditis (see Constrictive Pericarditis)
  • Physiology: xxxx
• Dynamic Hyperinflation (Severe)
  • Positive End-Expiratory Pressure (PEEP)/Auto-PEEP (see PEEP + Auto-PEEP)
    • Physiology: impairs venous return to right side of the heart
• Restrictive Cardiomyopathy (see Congestive Heart Failure)
• Hemothorax (see Pleural Effusion-Hemothorax,)
• Tamponade (see Tamponade)
• Tension Pneumothorax (see Pneumothorax)

Pulmonary Vascular

• Acute or Severe Pulmonary Hypertension (see Pulmonary Hypertension)
  • General Comments: typically causes right-sided heart failure
  • Acute Pulmonary Embolism (PE) (see Acute Pulmonary Embolism)
  • Chronic Thromboembolic Pulmonary Hypertension (CTEPH) (see Chronic Thromboembolic Pulmonary Hypertension)
  • Idiopathic Pulmonary Arterial Hypertension (IPAH) (see Idiopathic Pulmonary Arterial Hypertension,)
  • Other Causes of Severe Pumonary Hypertension
• Venous Air Embolism (see Air Embolism)