Hypotension causes

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ogheneochuko Ajari, MB.BS, MS [2]

Overview

Hypotension could be due to hormonal changes, medication side effects, anemia, heart or endocrine problems or caused by widening of blood vessels and low blood volume.

Causes

Life Threatening Causes

Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated.

• Anaphylaxis
• Aortic aneurysm rupture
• Bleeding
• Dehydration
• Hypothermia
• Shock

Common Causes

• ACE inhibitors
• Addison's disease
• Alpha blockers
• Beta blockers
• Bleeding
• Calcium channel blockers
• Diabetes mellitus
• Diuretics
• Hypoglycemia
• Hypothermia
• Hypovolemia
• Pregnancy
• Sepsis
• Shock
• Tricyclic antidepressants

Causes by Organ System

Cardiovascular	Aortic aneurysm rupture, aortic arch syndrome, aortic isthmus stenosis, aortic regurgitation, aortic stenosis, aortocaval compression syndrome, atrial myxoma, atrioventricular node conduction block, B type natriuretic peptide, baroceptor dysfunction in the elderly, capillary leak syndrome, cardiac tamponade, cardiogenic shock, carotid sinus hypersensitivity, carotid sinus syndrome, coarctation of aorta, complete heart block, constrictive pericarditis, cor triatriatum, dehydration, dissecting aortic aneurysm, distributive shock, Eisenmenger's syndrome, embolism, endotoxic shock, gray baby syndrome, heart arrhythmia, heart block, heart failure, heart injury, hemorrhagic shock, hemorrhagic shock and encephalopathy syndrome, hypertrophic obstructive cardiomyopathy, hypovolemic shock, Ibuprofen, idiopathic hypotension, iliac artery aneurysm rupture, internal bleeding, ischaemic heart disease, myocardial infarction, myocardial ischemia, obstructive shock, orthostatic hypotension, pericardial effusion, pericarditis, perimyocarditis, post-tussive syncope, postural hypotension, pulmonary embolism, shock, sick sinus syndrome, supraventricular tachycardia , syncope, tetralogy of Fallot, traumatic shock, tricuspid stenosis, vasovagal syncope, ventricular fibrillation, WPW syndrome
Chemical / poisoning	Acetaldehyde, adiponitrile , copper, cyanides, demeton-S-methyl, diazinon , dioxathion, disulfoton , ethion , fensulfothion, fenthion, honey bee bite, indian tobacco, malathion, methidathion, methiocarb, methomyl, mushroom poisoning , parathion, phosdrin, poison hemlock, profenofos, scorpion bite, sodium nitrite, terbufos, tetraethyl pyrophosphate , tetrodotoxin, tobacco , wasp bite
Dermatologic	Gray baby syndrome, mastocytosis
Drug Side Effect	Acetaminophen and Oxycodone, Acetophenazine, alcuronium, alfuzosin, aliskiren, alseroxylon, ambenonium, ambrisentan, amifostine, aminoglutethimide, amitriptyline, amlodipine, amoxapine, amphotericin B, amrinone, amyl nitrate, antipsychotic agents, Amlodipine besylate and Valsartan, apomorphine, azilsartan medoxomil, B type natriuretic peptide, baclofen, beta blockers, bethanechol, bethanidine, bortezomib, bosentan, bretylium, bromocriptine, bupivacaine, cabergoline, calcium channel blockers, candesartan, captopril, chloroquine, chlorpheniramine, chlorpromazine, chlorthalidone, cilazapril, cinacalcet, cinnarizine, clevidipine, clomipramine, clonidine, colchicine, cyclobenzaprine, deserpidine, desferrioxamine, desipramine, dexmedetomidine, diazoxide, dichlorvos , dicobalt edetate, dicrotophos , diltiazem, diphenhydramine, dipyridamole, disopyramide, distigmine, diuretics, donepezil , dothiepin, doxazosin, doxepin, enalapril, epidural anaesthesia, eplerenone, epoprostenol, etoposide, febuxostat, felodipine , fenoldopam, fentanyl, formoterol, fosinopril, general anaesthesia, gentamicin, glyceryl trinitrate, granulocyte-macrophage colony stimulating factor, gray baby syndrome, guanadrel, guanethidine, guanfacine, haloperidol, hexamethonium, hydralazine, hydroxyzine, imipramine, indapamide, Indomethacin, indoramin, interleukin 2, iodine containing radiocontrast media, irbesartan, isosorbide dinitrate, isosorbide mononitrate, isoxsuprine, isradipine, ketanserin, labetalol, l-dopa, Levalbuterol, levomepromazine, levosimendan, lidocaine , lisinopril, Lisinopril and Hydrochlorothiazide, lithium, lofexidine, losartan, mecamylamine, Methocarbamol, methyldopa, metirosine, metoclopramide, metolazone, minoxidil, morphine, moxonidine, nefazodone, neostigmine, niacin, nicorandil, nifedipine, nimodipine, nitroprusside, nortriptyline, olanzapine, olmesartan, omapatrilat, opioid poisoning, oxcarbazepine, paliperidone, Pentamidine Isethionate, perazine, pergolide, phenothiazines, phenoxybenzamine, phentolamine, pimobendan, pinacidil, pipothiazine, piribedil, pramipexole, prazosin, Prochlorperazine, protamine sulfate, protriptyline, quetiapine, ramipril, rasagiline, reboxetine, reserpine, rilmenidine, risperidone, rituximab, ropinirole, rotigotine, sassafras oil, serotonin syndrome, sildenafil, silodosin, sodium nitroprusside, spironolactone, streptokinase, sulphonamides, tacrine, tadalafil, tamsulosin, terazosin, tetrabenazine, tizanidine, tolazoline, tramadol, travoprost, treprostinil, trifluperidol, trimethaphan, trimipramine, tubocurarine, urapidil, valerian, valsartan, vardenafil, verapamil, ziconotide, zonisamide, zotepine
Ear Nose Throat	No underlying causes
Endocrine	Achalasia-addisonianism-alacrima syndrome, ACTH deficiency, Addison's disease, addisonian crisis, adrenal hemorrhage, adrenogenital syndrome, adrenoleukodystrophy , Allgrove syndrome, APECED syndrome , B type natriuretic peptide, carcinoid syndrome , congenital adrenal hyperplasia, diabetes insipidus, diabetic autonomic neuropathy, diabetic ketoacidosis, hyperosmolar hyperglycemic nonketotic coma, hypoaldosteronism, hyporeninemic hypoaldosteronism, hypothyroidism, Myxedema, myxedema coma, panhypopituitarism, pituitary insufficiency, pseudohypoaldosteronism, Renon-Delille syndrome, serotonin syndrome, triple-A syndrome
Environmental	Snake bite, zero gravity
Gastroenterologic	Achalasia-addisonianism-alacrima syndrome, acute liver failure , acute pancreatitis, acute viral gastroenteritis, Allgrove syndrome, bowel strangulation, deglutition syncope, diarrhea, duodenal ulcer bleeding, gastric ulcer bleeding, gastric volvulus, hepatic vein thrombosis, hepatitis, intususception, mastocytosis , necrotizing enterocolitis, paralytic ileus, peritonitis , postprandial hypotension, retroperitoneal haemorrhage, small bowel obstruction, splenic rupture, superior mesenteric artery occlusion, triple A syndrome, tropical sprue , variceal bleeding, vomiting
Genetic	Achalasia-addisonianism-alacrima syndrome, acute intermittent porphyria, Allgrove syndrome, APECED syndrome, Bartter syndrome, corticosteroid-binding globulin deficiency , familial juvenile hyperuricemic nephropathy type 2, hereditary peripheral nervous disorder, hereditary sensory and autonomic neuropathy type 3, pseudohypoaldosteronism, Renon-Delille syndrome, Riley-Day syndrome, triple A syndrome, Wohlwill-Andrade syndrome
Hematologic	Acute intermittent porphyria, anemia
Iatrogenic	After a major surgery, blood transfusion , dialyzer hypersensitivity syndrome, epidural anesthesia, gastric acid stimulation test using histamines, general anesthesia, mechanical ventilation, post-operative, renal dialysis, transfusion reaction
Infectious Disease	Acute viral gastroenteritis, botulism, cholera, dengue hemorrhagic fever, hantavirus, lassa fever, rocky mountain spotted fever , septic shock, septicemia , toxic shock syndrome, vibrio vulnificus, Waterhouse-Friederichsen syndrome, Weil syndrome
Musculoskeletal / Ortho	Cervical spine injury, fracture of bone, vertebral fracture
Neurologic	Autonomic failure, autonomic neuropathy, Binswanger's disease , Bradbury-Eggleston syndrome, diabetic autonomic neuropathy, DOPA decarboxylase deficiency, dopamine beta hydroxylase deficiency, dysautonomia, glossopharyngeal neuralgia, Guillain-Barre syndrome, hemorrhagic shock and encephalopathy syndrome, hereditary peripheral nervous disorder, hereditary sensory and autonomic neuropathy type 3, multiple system atrophy, neurogenic shock, Parkinson's disease, polyradiculitis, Riley-Day syndrome, seizures, Shy-Drager syndrome, syringomyelia, tabes dorsalis, vasovagal syncope, Wohlwill-Andrade syndrome
Nutritional / Metabolic	Dehydration,excessive dieting,kwashiorkor
Obstetric/Gynecologic	Aortocaval compression syndrome, ectopic pregnancy rupture, ovarian hyperstimulation syndrome, postpartum haemorrhage, pregnancy, puerpural shock, septic abortion , uterine rupture
Oncologic	Atrial myxoma, carcinoid syndrome , mastocytosis , pheochromocytoma, serotonin-secreting tumor
Opthalmologic	No underlying causes
Overdose / Toxicity	Acetophenazine, alcuronium, alfuzosin, aliskiren, alseroxylon, ambenonium, ambrisentan, amifostine, aminoglutethimide, amitriptyline, amlodipine, amoxapine, amphotericin B, amrinone, antipsychotic agents, apomorphine, azilsartan medoxomil, baclofen, beta blockers, bethanechol, bethanidine, bortezomib, bosentan, bretylium, bromocriptine, bupivacaine, cabergoline, calcium channel blockers, candesartan, captopril, chloroquine, chlorpheniramine, chlorpromazine, chlorthalidone, cilazapril, cinnarizine, clevidipine, clomipramine, clonidine, colchicine, cyclobenzaprine, deserpidine, desferrioxamine, desipramine, dexmedetomidine, diazoxide, dichlorvos , dicobalt edetate, dicrotophos , diltiazem, diphenhydramine, dipyridamole, disopyramide, distigmine, diuretics, donepezil , dothiepin, doxazosin, doxepin, enalapril, epidural anaesthesia, eplerenone, epoprostenol, etoposide, felodipine , fenoldopam, fentanyl, fosinopril, general anaesthesia, glyceryl trinitrate, granulocyte-macrophage colony stimulating factor, guanadrel, guanethidine, guanfacine, haloperidol, hexamethonium, hydralazine, hydroxyzine, imipramine, indapamide, indoramin, interleukin 2, irbesartan, isosorbide dinitrate, isosorbide mononitrate, isoxsuprine, isradipine, ketanserin, labetalol, l-dopa, levomepromazine, levosimendan, lidocaine , lisinopril, lithium, lofexidine, losartan, magnesium overdose, mecamylamine, methyldopa, metirosine, metolazone, minoxidil, morphine, moxonidine, nefazodone, neostigmine, niacin, nicorandil, nifedipine, nimodipine, nitroprusside, nortriptyline, olanzapine, , olmesartan, omapatrilat, opioid poisoning, paliperidone, pentamidine, perazine, pergolide, phenothiazines, phenoxybenzamine, phentolamine, pimobendan, pinacidil, pipothiazine, piribedil, pramipexole, prazosin, protamine sulfate, protriptyline, quetiapine, ramipril, rasagiline, reboxetine, reserpine, rilmenidine, risperidone, rituximab, ropinirole, rotigotine, sassafras oil, sildenafil, silodosin, sodium nitroprusside, spironolactone, streptokinase, sulphonamides, tacrine, tadalafil, tamsulosin, terazosin, tetrabenazine, tizanidine, tolazoline, tramadol, treprostinil, trifluperidol, trimethaphan, trimipramine, tubocurarine, urapidil, valerian, valsartan, vardenafil, verapamil, ziconotide, zotepine
Psychiatric	Anorexia nervosa, depression
Pulmonary	Post-tussive syncope, pulmonary edema, pulmonary embolism, tension pneumothorax
Renal / Electrolyte	Bartter syndrome, dehydration, familial juvenile hyperuricemic nephropathy type 2, hypermagnesaemia, hypokalemia, hyponatremia
Rheum / Immune / Allergy	Amyloidosis, anaphylactic shock, anaphylactoid reaction, blood transfusion , dialyzer hypersensitivity syndrome, food additive allergy, Guillain-Barre syndrome, honey bee bite, mastocytosis, scorpion bite, transfusion reaction, urticaria, wasp bite, Wohlwill-Andrade syndrome, x-ray studies using contrast media
Sexual	Renon-Delille syndrome
Trauma	Blood vessel trauma, burns, cervical spine injury, chemical burn, fracture of bone, heart injury, pericardial effusion, shaken baby syndrome, tension pneumothorax, traumatic shock
Urologic	No underlying causes
Dental	No underlying causes
Miscellaneous	Alcohol, alcohol withdrawal syndrome, decompression sickness, deglutition syncope, dehydration, fatigue, heat exhaustion, hypothermia, insufficient fluid intake, low salt diet, micturition syncope, prolonged bed rest, snake bite, syncope, volume depletion , zero gravity

Causes in Alphabetical Order

• Abdominal aortic aneurysm
• Acetaldehyde
• Acetophenazine
• Achalasia-addisonianism-alacrima syndrome
• ACTH deficiency
• Acute intermittent porphyria
• Acute liver failure
• Acute pancreatitis
• Acute viral gastroenteritis
• Addisonian crisis
• Addison's disease
• Adiponitrile
• Adrenal cortex insufficiency
• Adrenal hemorrhage
• Adrenogenital syndrome
• Adrenoleukodystrophy
• After a major surgery
• Alcohol
• Alcohol withdrawal syndrome
• Alcuronium
• Alfuzosin
• Aliskiren
• Allgrove syndrome
• Alseroxylon
• Ambenonium
• Ambrisentan
• Amifostine
• Aminoglutethimide
• Amitriptyline
• Amlodipine
• Amoxapine
• Amphotericin B
• Amrinone
• Amyl nitrate
• Amyloidosis
• Anaphylactic shock
• Anaphylactoid reaction
• Anemia
• Anorexia nervosa
• Antipsychotic agents
• Aortic aneurysm rupture
• Aortic arch syndrome
• Aortic isthmus stenosis
• Aortic regurgitation
• Aortic stenosis
• Aortic valve incompetence
• Aortocaval compression syndrome
• APECED syndrome
• Apomorphine
• Atrial myxoma
• Atrioventricular node conduction block
• Autoimmune adrenalitis
• Autonomic failure
• Autonomic neuropathy
• Azilsartan medoxomil
• B type natriuretic peptide
• Baclofen
• Baroceptor dysfunction in the elderly
• Bartter syndrome
• Beta blockers
• Bethanechol
• Bethanidine
• Binswanger's disease
• Blood transfusion
• Blood vessel trauma
• Bortezomib
• Bosentan
• Botulism
• Bowel strangulation
• Box jellyfish poisoning
• Bradbury-Eggleston syndrome
• Bretylium
• Bromocriptine
• Bupivacaine
• Burns
• Cabergoline
• Calcium channel blockers
• Candesartan
• Capillary leak syndrome
• Captopril
• Carcinoid syndrome
• Cardiac arrhythmias
• Cardiac failure, left sided
• Cardiac tamponade
• Cardiogenic shock
• Carotid sinus hypersensitivity
• Carotid sinus syndrome
• Cervical spine injury
• Charcot-Marie-Tooth disease
• Chemical burn
• Chloroquine
• Chlorpheniramine
• Chlorpromazine
• Chlortalidone
• Cholera
• Chronic pyelonephritis
• Chronic renal failure
• Cilazapril
• Cinnarizine
• Clevidipine
• Clomipramine
• Clonidine
• Coarctation of aorta
• Colchicine
• Complete heart block
• Congenital adrenal hyperplasia
• Constrictive pericarditis
• Copper
• Cor triatriatum
• Corticosteroid-binding globulin deficiency
• Cyanides
• Cyclobenzaprine
• Decompression sickness
• Deglutition syncope
• Dehydration
• Demeton-S-methyl
• Dengue hemorrhagic fever
• Depression
• Deserpidine
• Desferrioxamine
• Desipramine
• Dexmedetomidine
• Diabetes insipidus
• Diabetic autonomic neuropathy
• Diabetic ketoacidosis
• Dialyzer hypersensitivity syndrome
• Diarrhea
• Diazinon
• Diazoxide
• Dichlorvos
• Dicobalt edetate
• Dicrotophos
• Diltiazem
• Dioxathion
• Diphenhydramine
• Dipyridamole
• Disopyramide
• Dissecting aortic aneurysm
• Distigmine
• Distributive shock
• Disulfoton
• Diuretics
• Donepezil
• DOPA decarboxylase deficiency
• Dopamine
• Dopamine beta hydroxylase deficiency
• Dothiepin
• Doxazosin
• Doxepin
• Duodenal ulcer bleeding
• Dysautonomia
• Dysrhythmia
• Ectopic pregnancy rupture

• Eisenmenger's syndrome
• Embolism
• Enalapril
• Endotoxic shock
• Epidural anaesthesia
• Eplerenone
• Epoprostenol
• Ethion
• Etoposide
• Excessive dieting
• Excessive fluid loss through dialysis
• Familial juvenile hyperuricemic nephropathy type 2
• Fatigue
• Felodipine
• Fenoldopam
• Fensulfothion
• Fentanyl
• Fenthion
• Focal cerebral ischemia
• Food additive allergy
• Fosinopril
• Gastric acid stimulation test using histamines
• Gastric ulcer bleeding
• Gastric volvulus
• General anaesthesia
• Gitelman syndrome
• Glossopharyngeal neuralgia
• Glyceryl trinitrate
• Granulocyte-macrophage colony stimulating factor
• Gray baby syndrome
• Guanadrel
• Guanethidine
• Guanfacine
• Guillain-Barre syndrome
• Haloperidol
• Hantavirus
• Heart arrhythmia
• Heart block
• Heart failure
• Heart injury
• Heat exhaustion
• Hemorragic fever with renal syndrome
• Hemorrhage
• Hemorrhagic shock
• Hemorrhagic shock and encephalopathy syndrome
• Hepatic vein thrombosis
• Hepatitis
• Hereditary peripheral nervous disorder
• Hereditary sensory and autonomic neuropathy type 3
• Hexamethonium
• Histamine
• HIV
• Honey bee bite
• Hydralazine
• Hydroxyzine
• Hyperglycemia
• Hypermagnesemia
• Hyperosmolar hyperglycemic nonketotic coma
• Hypertrophic obstructive cardiomyopathy
• Hypoaldosteronism
• Hypokalemia
• Hyponatremia
• Hyporeninemic hypoaldosteronism
• Hypothermia
• Hypothyroidism
• Hypovolemia
• Hypovolemic shock
• Idiopathic hypotension
• Iliac artery aneurysm rupture
• Imipramine
• Indapamide
• Indian tobacco
• Indoramin
• Infliximab
• Insufficient fluid intake
• Interleukin 2
• Internal bleeding
• Intususception
• Iodine containing radiocontrast media
• Irbesartan
• Ischaemic heart disease
• Isoprenaline
• Isosorbide dinitrate
• Isosorbide mononitrate
• Isoxsuprine
• Isradipine
• Ketanserin
• Kwashiorkor
• Labetalol
• Lactic acidosis
• Lassa fever
• L-dopa
• Levomepromazine
• Levosimendan
• Lidocaine
• Lisinopril
• Lisinopril and Hydrochlorothiazide
• Lithium
• Lofexidine
• Losartan
• Low salt diet
• Lyme disease
• Lysuride
• Magnesium overdose
• Malathion
• MAOI
• Marijuana
• Mastocytosis
• Maternal hypotension syndrome
• Mecamylamine
• Mechanical ventilation
• Methidathion
• Methiocarb
• Methomyl
• Methyldopa
• Methyldopate
• Metirosine
• Metolazone
• Micturition syncope
• Minoxidil
• Mitral stenosis
• Mitral valve incompetence
• Morphine
• Moxonidine
• Multiple system atrophy
• Mushroom poisoning
• Myocardial infarction
• Myocardial ischemia
• Myocarditis
• Myxedema
• Myxedema coma
• Necrotizing enterocolitis
• Nefazodone
• Neostigmine
• Neurogenic shock
• Niacin
• Nicorandil
• Nifedipine
• Nimodipine
• Nitroprusside
• Nortriptyline
• Obstructive shock
• Olanzapine
• Olmesartan
• Omapatrilat
• Opioid poisoning
• Orthostatic hypotension
• Ovarian hyperstimulation syndrome
• Paliperidone
• Pancreatitis
• Panhypopituitarism
• Paralytic ileus
• Parathion

• Parkinson's disease
• Pentamidine
• Perazine
• Pergolide
• Pericardial effusion
• Pericarditis
• Perimyocarditis
• Peritonitis
• Phenothiazines
• Phenoxybenzamine
• Phentolamine
• Pheochromocytoma
• Phosdrin
• Pick's disease
• Pimobendan
• Pinacidil
• Pipothiazine
• Piribedil
• Pituitary insufficiency
• Poison hemlock
• Polyradiculitis
• Post-operative
• Postpartum haemorrhage
• Postprandial hypotension
• Post-tussive syncope
• Postural hypotension
• Pramipexole
• Prazosin
• Pregnancy
• Primary pulmonary hypertension
• Profenofos
• Prolonged bed-rest
• Protamine sulfate
• Protriptyline
• Pseudohypoaldosteronism
• Puerpural shock
• Pulmonary edema
• Pulmonary embolism
• Pulmonary stenosis
• Pyogenic pericarditis
• Quetiapine
• Ramipril
• Rasagiline
• Reboxetine
• Renal dialysis
• Renal tubular dysgenesis
• Renon-Delille syndrome
• Reserpine
• Respiratory acidosis
• Retroperitoneal haemorrhage
• Rickettsia prowazekii
• Riley-Day syndrome
• Rilmenidine
• Risperidone
• Rituximab
• Rocky mountain spotted fever
• Ropinirole
• Rotigotine
• Sarcoidosis
• Sassafras oil
• Scorpion bite
• Seizures
• Sepsis
• Septic abortion
• Septic shock
• Septicemia
• Serotonin syndrome
• Serotonin-secreting tumor
• Severe bleeding
• Shaken baby syndrome
• Shock
• Shy-Drager syndrome
• Sick sinus syndrome
• Sildenafil
• Silodosin
• Sjogren syndrome
• Small bowel obstruction
• Snake bite
• Sodium nitrite
• Sodium nitroprusside
• Spironolactone
• Splenic rupture
• Streptokinase
• Sulphonamides
• Superior mesenteric artery occlusion
• Supraventricular tachycardia
• Syncope
• Syphilis
• Syringomyelia
• Systemic candidiasis
• Tabes dorsalis
• Tacrine
• Tadalafil
• Tamsulosin
• Tension pneumothorax
• Terazosin
• Terbufos
• Tetrabenazine
• Tetraethyl pyrophosphate
• Tetralogy of Fallot
• Tetrodotoxin
• Thoracic aortic aneurysm
• Tizanidine
• Tobacco
• Tolazoline
• Toxic shock syndrome
• Toxoplasmosis
• Tramadol
• Transfusion reaction
• Trauma
• Traumatic shock
• Treprostinil
• Tricuspid stenosis
• Tricyclic antidepressants
• Trifluperidol
• Trimethaphan
• Trimipramine
• Triple A syndrome
• Tropical sprue
• Tuberculous pericarditis
• Tubocurarine
• Ulcerative colitis
• Urapidil
• Uremic pericarditis
• Urticaria
• Uterine rupture
• Valsartan
• Vancomycin resistant enterococcal bacteremia
• Vardenafil
• Variceal bleeding
• Vascular neuropathy
• Vasovagal syncope
• Ventricular familial preexcitation syndrome
• Ventricular fibrillation
• Verapamil
• Vertebral fracture
• Vibrio vulnificus
• Viral pericarditis
• VLCAD deficiency
• Volume depletion
• Vomiting
• Wasp bite
• Waterhouse-Friederichsen syndrome
• Weil syndrome
• Wohlwill-Andrade syndrome
• WPW syndrome
• Xamoterol
• X-ray studies using contrast media
• Zero gravity
• Ziconotide
• Zotepine