Hypotension and Low Blood Count

Patient

Q: What are causes of Low B/P ?... (Hypotension) My wife recently (October) had back surgery. She had low Blood Count going into surgery.... Since Surgery her Blood Count is still low and her blood pressure is very low (Usually around 70/48). She is seeing a Cardiologist who has prescribed some meds to increase her B/P.... Doesn't seem to be working (About 2 or 3 months) She is not retaining fluids but is concerned that long term might cause Liver Damage. Who should she see next ?

Symptoms:  Her B/P is sometimes a bit higher while laying/sitting but drops considerably when standing. See original text above...
Doctor

A:   Welcome to Ask The Doctor. We are here to help you.
Most Causes of Low BP are:
1. Cardiogenic shock.
2. Neurogenic Shock
3. Hypovolemic shock - Dehydration
4. Sepsis
5. Endocrinol causes.

Now, since she has got her Blood counts low, this can be a sign of septicemia, that might be causing low Blood Pressure (BP).
Now, since she is developing hypotension while getting up that is in standing position, this represents Hypovolemia, that can be due to dehydration or blood loss.
I would advise you to get following investigations:
1. Blood and Urine culture
2. Echo
3. Kidney function tests
4. Serum Electrolytes.
She should be admitted and intravenous fluid therapy and broad spectrum antibiotics should be given to her.
She should respond well to IV fluids and Antibiotics.
If any cardiac issue is found in Echo, she will be managed accordingly.
But with the description provided by you, Septic Shock and Hypovolemic shock are the first possibilities.
I hope it helps.
Stay Healthy.

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