Advertisement

Orthostatic Intolerance

  • Juan Idiaquez
  • Eduardo Benarroch
  • Martin Nogues
Chapter

Abstract

Clinical case. Differential diagnosis: neurally mediated syncope (VVS, situational syncope), cardiac conditions, seizure disorder, metabolic, orthostatic hypotension, psychogenic pseudo syncope. Diagnosis: careful history taking, tilt table testing. Main manifestations of VVS: precipitant factors, prodromal features, characteristics of loss of consciousness period, post syncopal manifestations. Aggravating factors, associated conditions. Therapy: proper education of the patient, drug therapy. Prognosis: natural history of VVS.

Bibliography

  1. 1.
    Sheldon RS, Grubb BP, Olshansky B, Shen WK, Calkins H, Brignole M, et al. 2015 heart rhythm society expert consensus statement on the diagnosis and treatment of postural tachycardia syndrome, inappropriate sinus tachycardia, and vasovagal syncope. Heart Rhythm. 2015;12:e41–63.CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    Wieling W, Thijs RD, van Dijk N, Wilde AA, Benditt DG, van Dijk JG. Symptoms and signs of syncope: a review of the link between physiology and clinical clues. Brain. 2009;132:2630–42.CrossRefPubMedGoogle Scholar
  3. 3.
    Wieling W, van Dijk N, de Lange FJ, Olde Nordkamp LR, Thijs RD, van Dijk JG, Linzer M, Sutton R. History taking as a diagnostic test in patients with syncope: developing expertise in syncope. Eur Heart J. 2015;36:277–80.CrossRefPubMedGoogle Scholar
  4. 4.
    Sutton R, Brignole M. Twenty-eight years of research permits reinterpretation of tilt-testing: hypotensive susceptibility rather than diagnosis. Eur Heart J. 2014;35:2211–2.CrossRefPubMedGoogle Scholar
  5. 5.
    Thieben MJ, Sandroni P, Sletten DM, Benrud-Larson LM, Fealey RD, et al. Postural orthostatic tachycardia syndrome: the Mayo clinic experience. Mayo Clin Proc. 2007;82:308–13.CrossRefPubMedGoogle Scholar
  6. 6.
    Benarroch EE. Postural tachycardia syndrome: a heterogeneous and multifactorial disorder. Mayo Clin Proc. 2012;87:1214–25.CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Jones PK, Shaw BH, Raj SR. Clinical challenges in the diagnosis and management of postural tachycardia syndrome. Pract Neurol. 2016;16:431–8.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG 2018

Authors and Affiliations

  • Juan Idiaquez
    • 1
  • Eduardo Benarroch
    • 2
  • Martin Nogues
    • 3
  1. 1.Universidad de ValparaisoViña del MarChile
  2. 2.Mayo ClinicRochesterUSA
  3. 3.Clinica FleniBuenos AiresArgentina

Personalised recommendations