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Sample Case Studies

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Abstract

In this chapter, we discuss some common sample case studies, including hypertension with depression, unexplained dizziness, cardiovascular autonomic neuropathy (CAN), sleep apnea, atrial fibrillation, cardiac pathology, diabetes, and depression. It is important to remember that the main goal of autonomic assessment and therapy is not to cure disease. While that may happen, the goal is to slow the progression of autonomic dysfunction and to minimize morbidity and mortality risk. This enables the physician to be more aggressive towards the primary disease and to promote and maintain wellness once the primary disease is controlled. For example, autonomic assessment may not cure heart disease, arrhythmia, COPD, diabetes, or Parkinson’s disease; treating documented autonomic dysfunction will lead to relief from dizziness, depression, secondary hypertension, sleep disorder, etc. This leads to reduced medication load, reducing the potential for conflicting or confounding therapies. This also leads to reduced hospitalization and helps to promote reduced healthcare costs for both the patient and the nation while improving outcomes.

Keywords

  • Autonomic Dysfunction
  • Takotsubo Cardiomyopathy
  • Ectopic Beat
  • Cardiovascular Autonomic Neuropathy
  • Postural Orthostatic Tachycardia Syndrome

These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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  • DOI: 10.1007/978-3-319-07371-2_30
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Notes

  1. 1.

    See “Possible Therapy Options.”

  2. 2.

    ALA

  3. 3.

    Carvedilol

  4. 4.

    Pamelor

  5. 5.

    Proamatine

  6. 6.

    See the trend plot (Fig. 30.10, middle graph). Note that the peak sympathetic (red) response to standing (section “F”) is comparable to that for Valsalva (section “D”). The reason why this does not show on the average is that the time duration of the stand is 300 s and that for Valsalva is 90 s. So the stand peaks often are averaged out.

References

  1. Arora RR, Bulgarelli RJ, Ghosh-Dastidar S, Colombo J. Autonomic mechanisms and therapeutic implications of postural diabetic cardiovascular abnormalities. J Diabetes Sci Technol. 2008;2(4):568–71.

    CrossRef  Google Scholar 

  2. Vinik AI, Murray GL. Autonomic neuropathy is treatable. US Endocrinol. 2008;2:82–4.

    Google Scholar 

  3. Arora RR, Iffrig K, Aysin E, Aysin B, Colombo J. Resting sympathetic/parasympathetic imbalance effects outcomes in geriatric heart failure patients. New Orleans: American College of Cardiology; 2007. 56th Annual Scientific Session.

    Google Scholar 

  4. Arora RR, Iffrig K, Colombo J. Geriatric female longevity associated with elevated parasympathetic tone. Can the same be affected in geriatric males? Presented at the American Autonomic Society’s 17th International Symposium on the Autonomic Nervous System, Rio Grande. Accessed 1–4 Nov 2006.

    Google Scholar 

  5. Waheed A, Ali MA, Jurivich DA, et al. Gender differences in longevity and autonomic function. Presented at the Geriatric Medicine Society Meeting, Chicago. Accessed 3–7 May 2006.

    Google Scholar 

  6. Arora RR, Iffrig K, Aysin E, Aysin B, Colombo J. Geriatric gender differences in parasympathetic tone may modify treatment of geriatric men and women. New Orleans: American College of Cardiology; 2007. 56th Annual Scientific Session.

    Google Scholar 

  7. Pereira E, Baker S, Bulgarelli RJ, Murray G, Arora RR, Colombo J. Gender differences in longevity and sympathovagal balance. Presented at the Cleveland Clinic Heart-Brain Summit, Cleveland Clinic Lou Ruvo Center for Brain Health, Las Vegas. Accessed 23–24 Sept 2010.

    Google Scholar 

  8. Umetani K, Singer DH, McCraty R, Atkinson M. Twenty-four hour time domain heart rate variability and heart rate: relations to age and gender over nine decades. JACC. 1998;31(3):593–601.

    CAS  PubMed  CrossRef  Google Scholar 

  9. Litchman JH, Bigger Jr JT, Blumenthal JA, et al. Depression and coronary heart disease recommendations for screening, referral, and treatment: a science advisory from the American Heart Association Prevention Committee of the Council on Cardiovascular Nursing, Council on Clinical Cardiology, Council on Epidemiology and Prevention, and Interdisciplinary Council on Quality of Care and Outcomes Research: endorsed by the American Psychiatric Association. Circulation. 2008;118:1768–75.

    CrossRef  Google Scholar 

  10. Sandroni P, Opfer-Gehrking TL, Singer W, Low PA. Pyridostigmine for treatment of neurogenic orthostatic hypotension: a follow up survey study. Clin Auton Res. 2005;15:51–3.

    PubMed  CrossRef  Google Scholar 

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Colombo, J., Arora, R., DePace, N.L., Vinik, A.I. (2015). Sample Case Studies. In: Clinical Autonomic Dysfunction. Springer, Cham. https://doi.org/10.1007/978-3-319-07371-2_30

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  • DOI: https://doi.org/10.1007/978-3-319-07371-2_30

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