Bijay mehta

Hypotension.
PRESSURE below 90/60 mmHg

of low blood pressure include:

1.Orthostatic hypotension (postural hypotension). This is a sudden drop in blood pressure when standing from a sitting position or after lying down. Causes include dehydration, long-term bed rest, pregnancy, certain medical conditions and some medications. This type of low blood pressure is common in older adults.

2.Postprandial hypotension. This drop in blood pressure occurs 1 to 2 hours after eating. It's most likely to affect older adults, especially those with high blood pressure or autonomic nervous system diseases such as Parkinson's disease. Eating small, low-carbohydrate meals, drinking more water, and avoiding alcohol might help reduce symptoms.

3.Neurally mediated hypotension. This is a blood pressure drop that happens after standing for long periods. This type of low blood pressure mostly affects young adults and children. It might result from miscommunication between the heart and the brain.

4.Multiple system atrophy with orthostatic hypotension. Also called Shy-Drager syndrome, this rare disorder affects the nervous system that controls involuntary functions such as blood pressure, heart rate, breathing and digestion. It's associated with having very high blood pressure while lying down.


Blurred or fading vision
Dizziness or lightheadedness
Fainting
Fatigue
Trouble concentrating
Nausea

low blood pressure can lead to a condition known as shock. Symptoms of shock include:
Confusion, especially in older people
Cold, clammy skin
Decrease in skin coloration (pallor)
Rapid, shallow breathing
Weak and rapid pulse


Medical condition

Pregnancy. Changes during pregnancy cause blood vessels to expand rapidly. The changes may cause blood pressure to drop. Low blood pressure is common in the first 24 weeks of pregnancy. Blood pressure usually returns to pre-pregnancy levels after giving birth.

Heart and heart valve conditions. A heart attack, heart failure, heart valve disease and an extremely low heart rate (bradycardia) can cause low blood pressure.

Hormone-related diseases (endocrine disorders). Conditions affecting the parathyroid or adrenal glands, such as Addison's disease, may cause blood pressure to drop. Low blood sugar (hypoglycemia) and, sometimes, diabetes also may lower blood pressure.

Dehydration. When the body doesn't have enough water, the amount of blood in the body (blood volume) decreases. This can cause blood pressure to drop. Fever, vomiting, severe diarrhea, overuse of diuretics and strenuous exercise can lead to dehydration.

Blood loss. Losing a lot of blood, such as from an injury or internal bleeding, also reduces blood volume, leading to a severe drop in blood pressure.

Severe infection (septicemia). When an infection in the body enters the bloodstream, it can lead to a life-threatening drop in blood pressure called septic shock.

Severe allergic reaction (anaphylaxis). Symptoms of a severe allergic reaction include a sudden and dramatic drop in blood pressure.

Lack of nutrients in the diet.
Low levels of vitamin B-12, folate and iron can keep the body from producing enough red blood cells (anemia), which can lead to low blood pressure.

# medications can cause low blood pressure, including:

Water pills (diuretics), such as furosemide (Lasix) and hydrochlorothiazide (Microzide)

Alpha blockers, such as prazosin (Minipress)

Beta blockers, such as atenolol (Tenormin) and propranolol (Inderal, Innopran XL, Hemangeol)

Drugs for Parkinson's disease, such as pramipexole (Mirapex) or those containing levodopa

Certain types of antidepressants (tricyclic antidepressants), including doxepin (Silenor) and imipramine (Tofranil)

Drugs for erectile dysfunction, including sildenafil (Revatio, Vi**ra) or tadalafil (Adcirca, Alyq, Cialis), particularly when taken with the heart medication nitroglycerin (Nitrostat, Nitro-Dur, Nitromist)

in relation to cardiac output: clinical signs and possible causes

1.High cardiac output sign
Warm hands
Pulsatile head movement
High-volume/strong pulse
Low venous pressure

Cause
Bleeding
Aortic stenosis and failure
compensation
Dysrhythmia
Chronic heart failure
Obstructive (pulmonary embolism/tamponade/ dynamic hyperinflation as in severe asthma)

2.Low cardiac output sign

Cold/clammy peripheries
Peripheral cyanosis
Raised venous pressure

Cause
Drug overdose (e.g.antihypertensive
Acidosis (e.g. diabetic
ketoacidosis)
Thyrotoxicosis
Beri-beri
Sepsis
Allergy



To diagnose low blood pressure (hypotension), your health care provider will do a physical exam and ask questions about your medical history.

1.Tilt table test. A tilt table test can evaluate how the body reacts to changes in position. The test involves lying on a table that's tilted to raise the upper part of the body, which mimics the movement from horizontal to a standing position. Straps hold the body in place. Heart rate and blood pressure are monitored during the test.

#

Low blood pressure (hypotension) without symptoms or with only mild symptoms rarely requires treatment.

If low blood pressure is causing symptoms, the treatment depends on the cause. For instance, if medication causes low blood pressure, your health care provider may recommend changing or stopping the medication or lowering the dose. Don't change or stop taking your medication without first talking to your care provider.

1.Use more salt. Experts usually recommend limiting salt (sodium) because it can raise blood pressure, sometimes dramatically. For people with low blood pressure, however, that can be a good thing. But too much sodium can lead to heart failure, especially in older adults. So it's important to check with a health care provider before increasing salt.

2.Drink more water. Fluids increase blood volume and help prevent dehydration, both of which are important in treating hypotension.

3.Wear compression stockings. Also called support stockings, these elastic stockings are commonly used to relieve the pain and swelling of varicose veins. They improve blood flow from the legs to the heart. Some people tolerate elastic abdominal binders better than they do compression stockings.

4.Medications.
Several drugs are available to treat low blood pressure that occurs when standing up (orthostatic hypotension). For example, the drug fludrocortisone boosts blood volume. It's often used to treat orthostatic hypotension.

If you have long-term (chronic) orthostatic hypotension, midodrine (Orvaten) may be prescribed to raise standing blood pressure levels. This drug reduces the ability of the blood vessels to expand, which raises blood pressure.

Do Ca & PTH level.
If normal, then it's Pseudohypoparathyroidism.

If abnormal, then it's Albright’s hereditary osteodystrophy.

Someone graduated at the age of 22, but waited 5 years before securing a good job.

Someone became a CEO at 25, and died at 50.
While another became a CEO at 50, and lived to 90 years.

Someone is still single, while someone from his school group has become grandfather.

Obama retired at 55 & Trump started at 70.

Everyone in this world works based on their time zone.

People around you might seem ahead of you & some might seem to be behind you.

But everyone is running their own race, in their own time.

Do not envy them.
They are in their time zone, and you are in yours.

So, relax.

You're not late.
You're not early.
You are very much on time.

This HiP-CT scan reveals the vasculature within a lung lobe from a 54-year-old male who died of COVID-19. HIP-CT scans show that in severe COVID-19 cases, the lungs' blood vessels are severely damaged: Here, airspaces are colored with cyan, open blood vessels are colored in red, and blocked, damaged blood vessels are colored in yellow.

Developed Compartment syndrome so fasciotomy was done.