Cardiovascular instability in trauma: ______tension - ______cardia

• A. Hypotension, bradycardia
• B. Hypertension, tachycardia
• C. Hypotension, tachycardia
• D. Hypertension, bradycardia

Answer: (A)

Cardiovascular instability in trauma can arise from neurogenic shock when a spinal cord injury disrupts sympathetic outflow. Without sympathetic stimulation, blood vessels dilate and blood pressure falls, and the heart rate tends to slow because the vagus becomes relatively unopposed. That combination exactly matches hypotension with bradycardia. This is different from hemorrhagic shock, where blood loss typically causes hypotension with reflex tachycardia as the body tries to maintain perfusion. Recognizing this pattern points toward a spinal injury above the level that preserves sympathetic tone, guiding management toward spinal stabilization, careful fluid and vasopressor use, and ongoing hemodynamic monitoring.