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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.
Rates are highest between the ages of 10–30 years old. This is likely because of the high rates of vasovagal syncope in the young adult population. Older adults are more likely to have orthostatic or cardiac syncope. Syncope affects about three to six out of every thousand people each year. [1] It is more common in older people and females. [7]
Orthostatic hypotension can be a side effect of certain antidepressants, such as tricyclics [23] or monoamine oxidase inhibitors (MAOIs) [24] Alcohol can potentiate orthostatic hypotension to the point of syncope. [25] Orthostatic hypotension can also be a side effect of alpha-1 blockers (alpha 1 adrenergic blocking agents).
Reflex syncope can occur in otherwise healthy individuals, and has many possible causes, often trivial ones such as prolonged standing with the legs locked. [citation needed] The main danger of vasovagal syncope (or dizzy spells from vertigo) is the risk of injury by falling while unconscious.
Orthostatic intolerance (OI) is the development of symptoms when standing upright that are relieved when reclining. [1] There are many types of orthostatic intolerance. OI can be a subcategory of dysautonomia , a disorder of the autonomic nervous system [ 2 ] occurring when an individual stands up. [ 3 ]
Orthostatic vital signs are also taken after surgery. [7] A patient is considered to have orthostatic hypotension when the systolic blood pressure falls by more than 20 mm Hg, the diastolic blood pressure falls by more than 10 mm Hg, or the pulse rises by more than 20 beats per minute within 3 minutes of standing [5] [7]
Sympathetic failure manifests itself as orthostatic hypotension and anhidrosis. Orthostatic symptoms, which include lightheadedness, dizziness, or syncope upon standing and loss of postural reflex tachycardia, occur in 78% of patients. [1] Dry eyes and mouth are symptoms of parasympathetic failure caused by secretomotor dysfunction.
A tilt table test (TTT), occasionally called upright tilt testing (UTT), is a medical procedure often used to diagnose dysautonomia or syncope. Patients with symptoms of dizziness or lightheadedness, with or without a loss of consciousness ( fainting ), suspected to be associated with a drop in blood pressure or positional tachycardia are good ...