Dysautonomia, Postural Hypotension, and Syncope

SummaryRadioisotope renograms were obtained in the upright and prone position in 9 normal subjects, in 5 patients with untreated essential hypertension and in 21 hypertensives under treatment, showing moderate postural hypotension.No significant renographic change were seen in the two positions in normal subjects and untreated hypertensives. Treated hypertensives with postural hypotension showed significant impairment of renal function in the upright position in 15 cases and no change in 6. Renal creatinine clearance was lower in the group that showed renographic changes. Renography in the upright position is suggested as a convenient test for early diagnosis and follow-up of the adverse effects of antihypertensive treatment.

Download Full-text

Editorial: Postural hypotension in the elderly.

BMJ ◽

10.1136/bmj.4.5887.246 ◽

1973 ◽

Vol 4 (5887) ◽

pp. 246-247 ◽

Cited By ~ 4

Keyword(s):

Postural Hypotension ◽

The Elderly

Download Full-text

Preanesthetic severe postural hypotension following 5-aminolevulinic acid pretreatment in patients for photodynamic diagnosis-assisted urological surgery

JA Clinical Reports ◽

10.1186/s40981-019-0295-1 ◽

2019 ◽

Vol 5 (1) ◽

Cited By ~ 1

Author(s):

Tohru Shiratori ◽

Kunihisa Hotta ◽

Masaaki Satoh ◽

Chiaki Kiuchi ◽

Noriyuki Ogawa ◽

...

Keyword(s):

Postural Hypotension ◽

Aminolevulinic Acid ◽

Vital Signs ◽

Photodynamic Diagnosis ◽

Careful Monitoring ◽

High Concentration ◽

Acid Pretreatment ◽

Case Presentation ◽

Severe Hypotension ◽

Prolonged Hypotension

Abstract Background 5-Aminolevulinic acid (5-ALA) is utilized for photodynamic diagnosis-assisted (PDD) surgery. However, it has been associated with vasodilation, hence, occasional hypotension. Case presentation We encountered two patients who had severe postural hypotension following 5-ALA pretreatment prior to an operation. They were scheduled for urological PDD surgery, but upon standing to walk to the operation room, they felt sick because of severe hypotension. One of them underwent the surgery after recovery, but the other surgery was canceled due to a prolonged hypotension that lasted for more than a day. Conclusions Severe postural hypotension may develop as a result of the high concentration of porphyrin precursors, which may affect the nervous system. Severe postural hypotension may be due to 5-ALA-induced autonomic dysfunction as well as vasodilative action of 5-ALA. These observations suggest that in addition to the careful monitoring of patients’ vital signs, standing should be avoided following 5-ALA pretreatment.

Download Full-text