Cardiovascular findings in a patient with severe tetanus

We report a case of tetanus associated with the syndrome of sympathetic overactivity. BP changes were associated with changes in systemic vascular resistance index (SVRI). Cardiac index (CI) varied independently from changes in SVRI and was correlated with the stroke volume. Oxygen consumption during the hypotensive periods was normal. Among several pharmacologic agents, only curare was effective in decreasing the severity and number of the hypertensive episodes. Physical stimulation of the patient rapidly reversed the hypotension. The potential mechanisms involved in producing these cardiovascular abnormalities are discussed.