Initial orthostatic hypotension as a cause of recurrent syncope: a case report

A 60-year-old male patient with recurrent unexplained syncope on standing was studied. During continuous, noninvasive blood pressure (BP) recording with a Finapres device, an abnormally large and symptomatic initial decrease in systemic BP was documented. After 2 minutes of standing, BP had recovere...

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Bibliographic Details
Published in:Clinical autonomic research 2001-08, Vol.11 (4), p.269-270
Main Authors: Wieling, W, Harms, M P, Kortz, R A, Linzer, M
Format: Article
Language:English
Subjects:
Antidepressive Agents - adverse effects
Blood Pressure - physiology
Blood Pressure Determination
Depressive Disorder - complications
Depressive Disorder - drug therapy
Heart Rate - physiology
Humans
Hypotension, Orthostatic - complications
Hypotension, Orthostatic - physiopathology
Male
Middle Aged
Syncope - etiology
Syncope - physiopathology
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Summary:A 60-year-old male patient with recurrent unexplained syncope on standing was studied. During continuous, noninvasive blood pressure (BP) recording with a Finapres device, an abnormally large and symptomatic initial decrease in systemic BP was documented. After 2 minutes of standing, BP had recovered. The transient decrease in BP was attributed to the use of a combination of antidepressants known to interfere with sympathetic function. This case shows the importance of continuous, noninvasive BP measurement on standing: routine intermittent BP recording would have missed the abnormality. In patients using medications such as antidepressants, initial transient hypotension should be considered as the cause of falls and syncope.
ISSN:0959-9851
1619-1560
DOI:10.1007/bf02298960