Recall that MAP = (cardiac output) x (systemic vascular resistance)

Consequently, a patient can be normotensive due to increased SVR despite a very low cardiac output and shock. In fact, normotensive shock may have worse outcomes compared to patients with isolated hypotension. 

Take home points: 

• Shock does not equal hypotension
• In critically ill patients with reduced cardiac output, additionally use other markers for end-organ perfusion (mental status, renal function/urine output, LFTs, cap refill, lactate etc.) to assess for possible shock

References

Yerasi C, Case BC, Pahuja M, et al. "The Need for Additional Phenotyping When Defining Cardiogenic Shock." JACC Cardiovasc Interv. 2022;15(8):890-895.