A long-suffering have bleeding oesophageal varices cause by cirrhosis of the liver (i.e. portal hypertension)...?
Why does he have systolic hypotension (105/85mmHg)? I know there would be some kind of hypotension due to the hypovolaemia cause by the variceal bleeding, but why is the diastolic pressure still normal?
Answers:
I dont know the answer but maybe i can stear you in a new direction on thinking? Liver produce clotting factor factor 1, 2 3, 4, etc.. Cirrhosis can cause factor deficits. liver also produce anti clotting factors such as factor s. Suppose the liver is not producing plenty anticlotting factors. The plateletes can aggergate on the walls of blood vessels making the vessels smaller quantity elastic which will increase blood pressure during heart contraction. During diastolic, the pressure remains normal because the vessels still contain plenty elasticity to maintain normal blood pressure? This is a theory i freshly made up in 2 minutes. Does it sound logical or will it help you to solve your problem?
If the body be hypovolemic, there would be a natural vasoconstrictive response anyway, so depending on the degree of hypololemia, that might be plenty to maintain the diastolic pressure even in the presence of a bleed, but with a reduced pulse pressure. Also, lacking further information, it's probably not possible to say whether the reduced systolic pressure is due only to blood loss alone, or if here are comorbidities that are also lowering the systolic pressure.
I'm not entirely sure about this answer, its just how I feel.
I don't think bleeding from a few esophageal varices would be enough to cause a significant hypovolemia which can't be corrected by the carotid reflex. So your thinking low pressure is due to bleeding-->hypovolemia is probably wrong. And I'm most spot on the clotting factor theory in Answer 1 is also wrong.
My theory is close to this:
Liver cirrhosis means liver failure. So the liver won't be producing what it normally produces. Almost adjectives of the plasma proteins are produced by the liver. In absence of these plasma proteins, plasma oncotic pressure falls & osmolality of the blood will increase. This will cause water from the plasma to move into the interstitial compartment. So plasma (blood) volume will dribble.
Systolic blood pressure depends on cardiac output. As total blood volume falls, so will the cardiac output. Resulting in drop of systolic BP.
As diastolic BP depends on peripheral resistance, and nothing happen to the vessels in this case finances the diastolic BP would stay put.
Thats how I think it wold happen Hope I helped.
Download Free Medical eBooks at:
http://rajamed.blogspot.com Source(s): med student
Related Questions:
Can my eye doctor diagnose conjunctivitis and prescribe drops? Or can solitary my GP do that?
Crohn's disease or what? Need backing asap!?
If i passed a home drug trial will i intervene one donate at work?
Answers:
I dont know the answer but maybe i can stear you in a new direction on thinking? Liver produce clotting factor factor 1, 2 3, 4, etc.. Cirrhosis can cause factor deficits. liver also produce anti clotting factors such as factor s. Suppose the liver is not producing plenty anticlotting factors. The plateletes can aggergate on the walls of blood vessels making the vessels smaller quantity elastic which will increase blood pressure during heart contraction. During diastolic, the pressure remains normal because the vessels still contain plenty elasticity to maintain normal blood pressure? This is a theory i freshly made up in 2 minutes. Does it sound logical or will it help you to solve your problem?
If the body be hypovolemic, there would be a natural vasoconstrictive response anyway, so depending on the degree of hypololemia, that might be plenty to maintain the diastolic pressure even in the presence of a bleed, but with a reduced pulse pressure. Also, lacking further information, it's probably not possible to say whether the reduced systolic pressure is due only to blood loss alone, or if here are comorbidities that are also lowering the systolic pressure.
I'm not entirely sure about this answer, its just how I feel.
I don't think bleeding from a few esophageal varices would be enough to cause a significant hypovolemia which can't be corrected by the carotid reflex. So your thinking low pressure is due to bleeding-->hypovolemia is probably wrong. And I'm most spot on the clotting factor theory in Answer 1 is also wrong.
My theory is close to this:
Liver cirrhosis means liver failure. So the liver won't be producing what it normally produces. Almost adjectives of the plasma proteins are produced by the liver. In absence of these plasma proteins, plasma oncotic pressure falls & osmolality of the blood will increase. This will cause water from the plasma to move into the interstitial compartment. So plasma (blood) volume will dribble.
Systolic blood pressure depends on cardiac output. As total blood volume falls, so will the cardiac output. Resulting in drop of systolic BP.
As diastolic BP depends on peripheral resistance, and nothing happen to the vessels in this case finances the diastolic BP would stay put.
Thats how I think it wold happen Hope I helped.
Download Free Medical eBooks at:
http://rajamed.blogspot.com Source(s): med student
Related Questions: