Which finding best characterizes neurogenic shock after a spinal cord injury?

Which finding best characterizes neurogenic shock after a spinal cord injury?

• A. Bradycardia with hypotension
• B. Hypertension
• C. Tachycardia
• D. Warm, flushed skin

Answer: (A)

Neurogenic shock from a spinal cord injury results from a loss of sympathetic tone below the injury, so the heart and blood vessels come under unopposed parasympathetic influence. This leads to a slow heart rate and low blood pressure as the vessels fail to maintain tone. That combination—bradycardia with hypotension—is the hallmark feature of this condition. Skin is often warm and dry due to vasodilation, but the defining clinical picture centers on the slow pulse and low pressure. Hypertension would not occur because sympathetic output is reduced; tachycardia would be more typical of other shock types where compensatory mechanisms raise the heart rate; warm, flushed skin can occur but does not by itself define neurogenic shock in the context of a spinal injury.

Neurogenic shock from a spinal cord injury results from a loss of sympathetic tone below the injury, so the heart and blood vessels come under unopposed parasympathetic influence. This leads to a slow heart rate and low blood pressure as the vessels fail to maintain tone. That combination—bradycardia with hypotension—is the hallmark feature of this condition. Skin is often warm and dry due to vasodilation, but the defining clinical picture centers on the slow pulse and low pressure. Hypertension would not occur because sympathetic output is reduced; tachycardia would be more typical of other shock types where compensatory mechanisms raise the heart rate; warm, flushed skin can occur but does not by itself define neurogenic shock in the context of a spinal injury.