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Cushing reflex (also referred to as the vasopressor response, the Cushing effect, the Cushing reaction, the Cushing phenomenon, the Cushing response, or Cushing's Law) is a physiological nervous system response to increased intracranial pressure (ICP) that results in Cushing's triad of increased blood pressure, irregular breathing, and bradycardia. [1]
Intracranial pressure (ICP) is the pressure exerted by fluids such as cerebrospinal fluid (CSF) inside the skull and on the brain tissue. ICP is measured in millimeters of mercury and at rest, is normally 7–15 mmHg for a supine adult. This equals to 9–20 cmH 2 O, which is a common scale used in lumbar punctures. [1]
A diagnosis of bradycardia in adults is based on a heart rate of less than 60 BPM, [1] although some studies use a heart rate of less than 50 BPM. [34] This is usually determined either by palpation or ECG. [1] If symptoms occur, a determining electrolytes may help determine the underlying cause. [28]
Sinus bradycardia is a sinus rhythm with a reduced rate of electrical discharge from the sinoatrial node, resulting in a bradycardia, a heart rate that is lower than the normal range (60–100 beats per minute for adult humans).
A Comparison of International Guidelines on Goal Blood Pressure and Initial Therapy for Adults With Hypertension (adapted from JNC 8 guidelines [1]) Guideline Population Goal blood pressure (mmHg) Initial treatment options ESC 2024 [2] General 120–129/70–79
Neurogenic shock is diagnosed based on a person's symptoms and blood pressure levels. Neurogenic shock's presentation includes: [7] [8] - warm and pink skin - labored breathing - low blood pressure - dizziness - anxiety - history of trauma to head or upper spine. - if the injury is to the head or neck, hoarseness or difficulty swallowing may occur.
Often sinus node dysfunction produces no symptoms, especially early in the disease course. Signs and symptoms usually appear in more advanced disease and more than 50% of patients will present with syncope or transient near-fainting spells as well as bradycardias that are accompanied by rapid heart rhythms, referred to as tachycardia-bradycardia syndrome [4] [5] Other presenting signs or ...
It is only when bradycardia presents with signs and symptoms of shock that it requires emergency treatment with transcutaneous pacing. False capture with visible phantom beats [3] Some common causes of hemodynamically significant bradycardia include myocardial infarction, sinus node dysfunction and complete heart block. [citation needed]