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venous pooling

Pathology: - component of orthostatic hypotension - inadequate vasoconstrictor mechanisms in both arterioles & veins resulting in venous pooling, or hypovolemia - diminished blood volume - diminished venous return - standing causes a gravitational shift of 300-700 mL of intravascular fluid into the lower extremities & abdomen [1] - the gravitational pooling of blood results in a decrease pressure detected by baroreceptors in the heart, intrathoracic vessels & carotids resulting in autonomic responses to maintain cardiac output & cerebral perfusion - these autonomic baroreceptor responses mainly involve an increase in peripheral vasoconstriction - an increase in venous pooling in older adults is due to decreased skeletal muscle tone & increased venous compliance Clinical manifestations: - dizziness, orthostatic hypotension Complications: - falls in the elderly - a decrease in reflex peripheral vasocontriction is the most common cause of syncope [1]

General

sign/symptom

References

  1. Geriatrics Review Syllabus, American Geriatrics Society, 5th edition, 2002-2004 - Geriatric Review Syllabus, 10th edition (GRS10) Harper GM, Lyons WL, Potter JF (eds) American Geriatrics Society, 2019 - Geriatric Review Syllabus, 11th edition (GRS11) Harper GM, Lyons WL, Potter JF (eds) American Geriatrics Society, 2022