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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]
Symptoms of neurogenic shock are differentiated from other forms of shock by the lack of signs of the compensatory mechanisms triggered by the SNS, usual in other forms of shock. 'This SNS response is effected via release of epinephrine and norepinephrine , and signs of these neurotransmitters ' activity are typically absent where shock is of ...
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 ...
Many heathy young adults, and particularly well-trained athletes, have sinus bradycardia that is without symptoms. [5] This can include heart rates of less than 50 or 60 bpm or even less than 40 bpm. [5] Such individuals, without symptoms, do not require treatment. [5] Temporal correlation of symptoms with bradycardia is necessary for diagnosis ...
Any recent changes to patient's medication history, new symptoms such as chest pain, shortness of breath and palpitations, family history of sinus bradycardia, physical exam that reveals cyanosis, peripheral edema, altered mental status, dyspnea, rales and crackles are all relevant information to consider for differential diagnosis.
Certain medications, such as dobutamine and milrinone, improve the heart's ability to contract and can also be used. When these measures fail, more advanced options such as mechanical support devices or heart transplantation can be pursued. Cardiogenic shock is a condition that is difficult to fully reverse even with an early diagnosis. [4]
Due to these factors, heart rate and blood pressure responses are extremely variable and, therefore, cannot be relied upon as the sole means of diagnosis. [3] A key factor in the pathophysiology of hemorrhagic shock is the development of trauma-induced coagulopathy. Coagulopathy develops as a combination of several processes.
Reduced blood flow to the heart associated with coronary ischemia can result in inadequate oxygen supply to the heart muscle. [6] When oxygen supply to the heart is unable to keep up with oxygen demand from the muscle, the result is the characteristic symptoms of coronary ischemia, the most common of which is chest pain. [6]
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