Clinical manifestations of acute metabolic acidosis include:

a. Decreased cardiac contractility

b. Decreased catecholamine secretion

c. Peripheral arteriolar dilitation

The major cardiovascular effects of acute metabolic acidosis are peripheral arteriolar dilitation, decreased cardiac contractility, and central venous constriction. These may lead to cardiovascular collapse and pulmonary edema. Catecholamine secretion is stimulated by metabolic acidosis and in mild cases, heart rate may be increased. In addition to these cardiovascular effects, metabolic acidosis may also affect oxygen delivery by shifting the oxygen-hemoglobin disassociation curve to the right.