Last reviewed: 19 Sep 2021
Last updated: 24 Sep 2021

Summary

Differentials

Common

  • Nonhemorrhagic volume losses
  • Upper gastrointestinal bleed
  • Lower gastrointestinal bleed
  • Dialysis-induced hypotension
  • Trauma
  • Acute coronary syndrome
  • Acute heart failure
  • Dysrhythmia
  • Acute pulmonary embolism
  • Vasovagal syncope
  • Medication-related
  • Pregnancy (uncomplicated)
  • Sepsis
  • Chronic liver disease
  • Parkinson disease

Uncommon

  • Ruptured abdominal aortic aneurysm
  • Ectopic pregnancy
  • Retroperitoneal bleed
  • Severe acute pancreatitis
  • Carotid sinus syndrome (cardioinhibitory subtype)
  • Severe hypothyroidism
  • Tension pneumothorax
  • Cardiac tamponade
  • Situational syncope
  • Anaphylaxis
  • Carotid sinus syndrome (vasodepressor subtype)
  • Diabetic autonomic neuropathy
  • Multi-system atrophy
  • Post-stroke
  • Primary autonomic failure
  • Amyloidosis
  • Adrenal suppression (iatrogenic)
  • Addison disease
  • Hypopituitarism
  • Thiamine deficiency
  • Vitamin B12 deficiency
  • Carcinoid syndrome

Contributors

Authors

Fiona Kearney, MB, BCh, BAO, MRCPI

Consultant Geriatrician

Department of Healthcare of Older People

Nottingham University Hospitals NHS Trust

Queen’s Medical Centre

Nottingham

UK

Disclosures

FK is an author of a reference cited in this topic.

Alan Moore, MB, BCh, BAO, FRCPI

Consultant Geriatrician

Beaumont Hospital

Dublin

Honorary Senior Lecturer at Royal College of Surgeons

Ireland Medical School

Dublin

Republic of Ireland

Disclosures

AM is an author of a number of references cited in this topic.

Peer reviewers

Vidhu S. Paliwal, MD

Cardiologist

Skagit Valley Hospital

Mount Vernon

WA

Disclosures

VSP declares that he has no competing interests.

Gideon Caplan, MB, BS Syd, FRACP

Director

Geriatric Medicine

Prince of Wales Hospital

Sydney

Australia

Disclosures

GC declares that he has no competing interests.

Vasi Naganathan, MBBS, FRACP, MMed (Clin Epi), PhD, Grad Cert Med Ed

Academic Sydney Medical School

University of Sydney

Consultant Geriatrician

Concord Hospital Centre for Education and Research on Ageing

Concord

Australia

Disclosures

VN declares that he has no competing interests.

Andrew Parfitt, MBBS, FFAEM

Clinical Director

Acute Medicine

Associate Medical Director

Consultant Emergency Medicine

Guy's and St Thomas' NHS Foundation Trust

Clinical Lead and Consultant

Accident Emergency Medicine

St Thomas' Hospital

London

UK

Disclosures

AP declares that he has no competing interests.

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