Orthostatic Hypotension Management Algorithm

 • Hypovolemic?  Yes → Resuscitate

 • Volume Overloaded? No → Fludrocortisone

 • Supine Hypertension? No → Midodrine, Yes → Consider Pyridostigmine

Non-pharmacologic Management:

 • Abdominal binder, Compression stockings → Improves venous return and increases cardiac output

 • Increase PO intake, Increase salt intake → Increases intravascular volume

 • Head-up-tilt (HUT) position → Decrease in sodium and water excretion during the night → higher intravascular volume in the morning

 • Leg crossing with tension of the thigh, buttock and calf muscles (party position) → Improves venous return and increases cardiac output



Dr. Satya Patel @SatyaPatelMD



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