title: Shy-Drager syndrome and severe unexplained intraoperative hypotension responsive to vasopressin.
abstract: We describe the first case of Shy-Drager syndrome diagnosed on the basis of intraoperative hemodynamic changes. The initial hypertension in the supine position followed by severe hypotension after hydralazine administration, ultimately responsive to vasopressin, led to a diagnosis of Shy-Drager syndrome. We suggest that vasopressin may be the drug of choice in patients with Shy-Drager syndrome with refractory hypotension.
authors.affiliation: Anesthesiology Department, Jackson Memorial Hospital/University of Miami, Florida, USA. rvallejo@partners.org
authors.forename: Ricardo
authors.initials: R
authors.lastname: Vallejo
authors.forename: Gerard
authors.initials: G
authors.lastname: DeSouza
authors.forename: Jong
authors.initials: J
authors.lastname: Lee
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000368:Aged; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D007022:Hypotension / Q000188:drug therapy* / Q000503:physiopathology; D007431:Intraoperative Complications / Q000188:drug therapy* / Q000503:physiopathology*; D007741:Labetalol / Q000627:therapeutic use; D007871:Leg Ulcer / Q000601:surgery; D008297:Male; D016343:Monitoring, Intraoperative; D019578:Multiple System Atrophy / Q000503:physiopathology; D010656:Phenylephrine / Q000627:therapeutic use; D012791:Shy-Drager Syndrome / Q000503:physiopathology*; D014662:Vasoconstrictor Agents / Q000627:therapeutic use*; D014667:Vasopressins / Q000627:therapeutic use*
chemical_list: D000319:Adrenergic beta-Antagonists; D014662:Vasoconstrictor Agents; D014667:Vasopressins; D010656:Phenylephrine; D007741:Labetalol