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Sample Case Studies

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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.


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

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    See “Possible Therapy Options.”

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    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.


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Colombo, J., Arora, R., DePace, N.L., Vinik, A.I. (2015). Sample Case Studies. In: Clinical Autonomic Dysfunction. Springer, Cham.

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