en Medical-Surgical Care Medical-Surgical Care گزارش مورد/موارد Case/Series Report <h3 style="margin-top:3px"><span style="font-size:12pt"><span style="font-family:&quot;Times New Roman&quot;,serif"><strong><span style="font-size:10.0pt"><span style="font-family:&quot;Cambria&quot;,serif"><span style="color:#44546a">Aims:</span></span></span></strong> <span style="font-size:10.0pt"><span style="font-family:&quot;Cambria&quot;,serif">Postoperative hypotension is a common and potentially life-threatening complication, typically accompanied by compensatory tachycardia. The occurrence of persistent hypotension with relative bradycardia is unusual and suggests distinct mechanisms, such as conduction abnormalities, medication effects, electrolyte disturbances, or hypothermia. Prompt recognition of the underlying cause is essential to avoid adverse outcomes. This study reported an unusual case of preventable hypothermic shock.</span></span></span></span><br> <span style="font-size:12pt"><span style="font-family:&quot;Times New Roman&quot;,serif"><strong><span style="font-size:10.0pt"><span style="font-family:&quot;Cambria&quot;,serif"><span style="color:#44546a">Patients & Methods:</span></span></span></strong> <span style="font-size:10.0pt"><span style="font-family:&quot;Cambria&quot;,serif">This study described a 54-year-old woman who developed persistent hypotension (70/40mmHg) with relative bradycardia (55bpm) following a total abdominal hysterectomy under general anesthesia. Laboratory workup, electrocardiography, and echocardiography were unremarkable. Despite the administration of 2 liters of intravenous fluids, no improvement was observed. Her core temperature was 35.3&deg;C. Upon reassessment, a wet surgical drape was found underneath her back, causing hypothermia. Removal of the drape and active rewarming restored hemodynamic stability (blood pressure 110/70mmHg, heart rate 75bpm, temperature 36.3&deg;C), which was maintained throughout her hospitalization.</span></span></span></span><br> <span style="font-size:12pt"><span style="font-family:&quot;Times New Roman&quot;,serif"><strong><span style="font-size:10.0pt"><span style="font-family:&quot;Cambria&quot;,serif"><span style="color:#44546a">Findings:</span></span></span></strong> <span style="font-size:10.0pt"><span style="font-family:&quot;Cambria&quot;,serif">Hypothermia can impair cardiovascular stability through bradycardia, reduced myocardial contractility, vasodilation, and diminished catecholamine responsiveness. In this case, inadvertent perioperative hypothermia due to a wet drape was the sole cause of refractory hypotension with relative bradycardia. This highlights the importance of considering environmental and physical factors in the differential diagnosis when standard investigations are inconclusive.</span></span></span></span><br> <span style="font-size:12pt"><span style="font-family:&quot;Times New Roman&quot;,serif"><strong><span style="font-size:10.0pt"><span style="font-family:&quot;Cambria&quot;,serif"><span style="color:#44546a">Conclusion:</span></span></span></strong> <span style="font-size:10.0pt"><span style="font-family:&quot;Cambria&quot;,serif">Persistent hypotension with relative bradycardia in the postoperative setting should raise suspicion for hypothermia after excluding common causes.</span></span></span></span></h3> Hypotension,Bradycardia,Hypothermia,Shock,Perioperative Care, 233 236 http://jccs.yums.ac.ir/browse.php?a_code=A-10-102-3&slc_lang=en&sid=1 Z. Alizadeh 10031947532846006432 10031947532846006432 No Department of Anesthesiology, Faculty of Medicine, Yasuj University of Medical Sciences, Yasuj, Iran F. Zadehbagheri 10031947532846006433 10031947532846006433 No Department of Cardiology, Faculty of Medicine, Yasuj University of Medical Sciences, Yasuj, Iran S. Jokar 10031947532846006434 10031947532846006434 Yes Department of Internal Medicine, Faculty of Medicine, Yasuj University of Medical Sciences, Yasuj, Iran