Which hemodynamic change is most consistent with neurogenic shock after a high spinal cord injury?

Which hemodynamic change is most consistent with neurogenic shock after a high spinal cord injury?

• A. Hypotension with bradycardia
• B. Tachycardia
• C. Hypertension
• D. Normal heart rate

Answer: (A)

Neurogenic shock from a high spinal cord injury causes loss of sympathetic outflow to both the vessels and the heart. Without sympathetic tone, blood vessels lose their constriction and dilate, leading to a drop in systemic vascular resistance and pooling of blood in the venous system—this produces hypotension. The heart also loses sympathetic stimulation, while parasympathetic (vagal) influence remains, so the heart rate tends to slow, resulting in bradycardia. The combination of low blood pressure with a slow pulse is the hallmark of this condition. Tachycardia or hypertension would point to other types of shock, and a normal heart rate would not align with the loss of sympathetic control seen in high spinal injuries.

Neurogenic shock from a high spinal cord injury causes loss of sympathetic outflow to both the vessels and the heart. Without sympathetic tone, blood vessels lose their constriction and dilate, leading to a drop in systemic vascular resistance and pooling of blood in the venous system—this produces hypotension. The heart also loses sympathetic stimulation, while parasympathetic (vagal) influence remains, so the heart rate tends to slow, resulting in bradycardia. The combination of low blood pressure with a slow pulse is the hallmark of this condition. Tachycardia or hypertension would point to other types of shock, and a normal heart rate would not align with the loss of sympathetic control seen in high spinal injuries.