Peter Weissmann, MD; Michael T. Chin, MD, PhD; Arthur J. Moss, MD
Weissmann P, Chin MT, Moss AJ. Cardiac Tachypacing for Severe Refractory Idiopathic Orthostatic Hypotension. Ann Intern Med. 1992;116:650-651. doi: 10.7326/0003-4819-116-8-650
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Published: Ann Intern Med. 1992;116(8):650-651.
In 1925, Bradbury and Eggleston described three patients with marked postural decline in the blood pressure, fixed heart rate, anhidrosis, nocturnal polyuria, and impotence (1). This idiopathic disorder is caused by primary autonomic nervous system dysfunction, which may be central with multiple neurologic defects (the Shy-Drager Syndrome) (2) or peripheral with a defect limited to the efferent sympathetic nerves (3). Orthostatic hypotension usually develops insidiously over a period of years and eventually becomes functionally disabling. Patients experience orthostatic faintness and syncope, especially in the morning after they awaken.
Therapy for this disorder is unsatisfactory and usually involves a multifaceted approach
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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