Orthostatic Hypotension After SCI

Why does orthostatic hypotension occur after SCI?

• Loss of sympathetic vasoconstriction

• Venous pooling

• Reduced skeletal muscle pump

• Common early in rehabilitation

What blood pressure change defines orthostatic hypotension?

• Drop in systolic BP ≥20 mmHg

• OR drop in diastolic BP ≥10 mmHg

• Usually occurs after moving upright

What symptoms are common with orthostatic hypotension?

• Dizziness

• Lightheadedness

• Nausea

• Near-syncope

• Syncope

• “Blacking out”

How is orthostatic hypotension managed during rehab?

• Gradual upright progression

• Tilt table

• Compression stockings

• Abdominal binder

• Monitor vital signs

• Medication if indicated

What is the key difference between orthostatic hypotension and autonomic dysreflexia?

• Orthostatic hypotension:

  • BP too low

  • Recline/return toward supine

• Autonomic dysreflexia:

  • BP too high

  • Sit upright