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Low Blood Pressure (cont.)

Exams and Tests

The key to diagnosis is a good history and physical examination. If low blood pressure is found incidentally and no other symptoms exist, then documenting the lower readings will help remind the healthcare provider during future visits.

If the patient is symptomatic, documenting risk factors and exploring potential causes requires a detailed history of the situation; for example:

when symptoms occur,
associated complaints, and
a thorough review of past illnesses and medications.

Physical examination may include postural vital signs. The patient has the blood pressure and pulse rate taken when laying flat and again when standing (some may add a third set of measurements when sitting). If the blood pressure drops or the pulse rate increases, it may be an indicator of decreased intravascular volume from dehydration or bleeding. The rest of the examination will likely be directed by clues from the history, but may include palpation of the thyroid gland in the neck, listening to the heart and lungs, and examination of the abdomen and the extremities.

Blood tests may be done, again directed by findings in the history and physical examination.

An electrocardiogram (EKG or ECG) may be performed if the low blood pressure is thought to originate in the heart or if there is chest pain or shortness of breath associated with the low pressure.

Consideration for further testing will depend upon the potential underlying cause of low blood pressure.