AARON SPITAL, M.D.
To the editor: In the March issue, Fouad and colleagues (1) describe the cases of 11 patients who presented with "orthostatic intolerance" and "markedly decreased total blood volume" as determined by the radioactive albumin technique. The hypovolemia was presumably responsible for a significantly lower cardiac index and significantly higher total peripheral resistance than found in normal persons. Further support that these patients were hypovolemic was provided by a marked increase in heart rate in response to head-up tilt and an alleviation of symptoms with volume expansion. As no obvious cause for volume depletion could be found, the authors concluded that
SPITAL A. Idiopathic Hypovolemia. Ann Intern Med. ;105:304. doi: 10.7326/0003-4819-105-2-304_1
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Published: Ann Intern Med. 1986;105(2):304.
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