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Orthostatic syncope refers to syncope resulting from a postural decrease in blood pressure, termed orthostatic hypotension. [1]Orthostatic hypotension occurs when there is a persistent reduction in blood pressure of at least 20mmHg systolic or 10mmHg diastolic within three minutes of standing or being upright to 60 degrees on the head-up tilt table.
Orthostatic hypotension, also known as postural hypotension, [2] is a medical condition wherein a person's blood pressure drops when they are standing up (orthostasis) or sitting down. Primary orthostatic hypotension is also often referred to as neurogenic orthostatic hypotension. [ 3 ]
The heart resumes beating normally upon being returned to a flat or head-down position. A drop in blood pressure during the tilt table test is indicative of orthostatic hypotension. A marked increase in heart rate in the absence of orthostatic hypotension is indicative of postural orthostatic tachycardia syndrome. [6]
Dysautonomia, autonomic failure, or autonomic dysfunction is a condition in which the autonomic nervous system (ANS) does not work properly. This condition may affect the functioning of the heart, bladder, intestines, sweat glands, pupils, and blood vessels.
Fludrocortisone is the first-line therapy (in the absence of heart failure) for patients with chronic hypotension or resistant orthostatic hypotension. [17] It works by increasing the intravascular volume. [17] Midodrine is a therapy used for severe orthostatic hypotension, and works by increasing peripheral vascular resistance. [17]
Postural orthostatic tachycardia syndrome (POTS) is a condition characterized by an abnormally large increase in heart rate upon sitting up or standing. [1] POTS is a disorder of the autonomic nervous system that can lead to a variety of symptoms, [10] including lightheadedness, brain fog, blurred vision, weakness, fatigue, headaches, heart palpitations, exercise intolerance, nausea ...
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