Cardiogenic ⊕ Distributive Hypotension

• This page describes the DDx for hypotension deriving from the combination of distributive hypotension (i.e. ↑ peripheral vascular vasodilatation → vasoplegia) +/- cardiogenic hypotension (i.e. ↓ cardiac output)

• Cardiogenic → Distributive
• ⊖ Cardiogenic Shock*: ischemia → secondary vasodilatation
• ⊕ Cardiogenic Shock: frank cardiogenic shock → ischemia, MCS

*refers to absence of true cardiogenic hypotension, yet underlying myocardial injury still drives systemic inflammation & vasodilatation

• Distributive → Cardiogenic
• Septic cardiomyopathy
• Stress cardiomyopathy +/- LVOT obstruction
• LVOT obstructive 2/2 high-output state
• Infective endocarditis → acute valvulopathy

• **Trigger** → Distributive ⊕ Cardiogenic
• Global ischemia (e.g. post-arrest)

Pathophysiology ✨

• Mixed Cardiogenic-Vasodilatory Shock: Current Insights and Future Directions

• Posterior OMI on Chronic RBBB (case report)