Which of the following is a sign of local anesthesia cardiovascular toxicity?

• A. Shivering
• B. Hypotension
• C. Syncope
• D. Sweating

Answer: (B)

Cardiovascular toxicity from local anesthesia occurs when enough anesthetic enters the bloodstream to directly depress the heart and blood vessels, causing vasodilation and reduced myocardial contractility. This leads to a fall in blood pressure, so hypotension is a hallmark sign of cardiovascular involvement. Shivering is more related to CNS or thermoregulatory responses, sweating is an autonomic response not specific to cardiovascular toxicity, and syncope can occur if blood pressure or heart rhythm collapses but is not the direct sign of cardiovascular toxicity itself.