- kevinLv 61 decade agoFavorite Answer
The term "cryptic shock" is often used for patients with deceptively normal hemodynamic parameters, yet presenting high risk for morbidity and mortality because of global ischemia with increased lactate blood level. If the blood pressure is normal, but lactate blood level is high secondary to global tissue ischemia, some call this condition "normotensive shock" instead of "cryptic shock". Actually, some patients can even be in "hypertensive cryptic shock" (for instance in cardiogenic shock with marked sympathetic system activation and or during a hypertensive crisis due to pheochromocytoma), with evidence ot tissue hypoxia (high lactate blood level).
It is important to note that many physicians do not believe that patients with normal blood pressure can be in shock. For those non-believers, they should at least admit that a previously chronically hypertensive patient with blood pressures running chronically in the 180/100 mmHg range, and presenting to the emergency room department with a blood pressure of 100/70 ("normal BP"), can be in full blown shock (in these cases, compensatory mechanisms are at play and maintain some blood pressure through severe increase in systemic vascular resistance thereby severe inducing tissue ischemia).