Which statement best describes the neurogenic shock triad?

Which statement best describes the neurogenic shock triad?

• A. Hypertension with tachycardia and vasoconstriction
• B. Hypotension without tachycardia, bradycardia, peripheral vasodilation
• C. Hypotension with tachycardia, peripheral vasoconstriction
• D. Hypertension with bradycardia, peripheral vasodilation

Answer: (B)

Neurogenic shock stems from loss of sympathetic tone to the vessels after a spinal cord injury, especially above the mid-thoracic level. Without sympathetic input, the peripheral vessels dilate (vasodilation), causing a drop in systemic vascular resistance and blood pressure. At the same time, the heart loses sympathetic drive to speed up, so the heart rate tends to be bradycardic rather than tachycardic. This combination—hypotension with bradycardia and peripheral vasodilation—embodies the characteristic presentation. The absence of tachycardia helps distinguish neurogenic shock from other shock types where a faster heart rate is expected to compensate for low pressure.

Neurogenic shock stems from loss of sympathetic tone to the vessels after a spinal cord injury, especially above the mid-thoracic level. Without sympathetic input, the peripheral vessels dilate (vasodilation), causing a drop in systemic vascular resistance and blood pressure. At the same time, the heart loses sympathetic drive to speed up, so the heart rate tends to be bradycardic rather than tachycardic. This combination—hypotension with bradycardia and peripheral vasodilation—embodies the characteristic presentation. The absence of tachycardia helps distinguish neurogenic shock from other shock types where a faster heart rate is expected to compensate for low pressure.