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Bleeding...when the HR and BP mislead you

We always rely on the classical clinical picture of hypotension and tachycardia to make the diagnosis of hypovolemia .....but here is the two examples when the classical way may mislead you .... Beta-blockers or calcium channel blockers may blunt the usual heart rate response to severe bleeding. Among patients with chronic hypertension, a "normal" blood pressure may actually suggest relative hypotension.