What is your diagnostic and therapeutic approach to hospitalized patients with persistent hypotension (MAP <65) of uncertain etiology, but no evidence of hypoperfusion or shock physiology?

Clinical concern for MAPs <65 mmHg has become ingrained due to extensive literature on septic shock, but there is little evidence to support intervening solely at this threshold in patients without evidence of hypoperfusion. My initial approach to hypotension is therefore diagnostic: confirm it is r...

I agree with Dr. @Dr. First Last. I would add that once I confirm the hypotension is real and assess chronicity, I try to evaluate the situation in terms of perfusion rather than pressure. A MAP <65 may be seen in some patients with chronic low blood pressure, autonomic dysfunction, cirrhosis, or in...