title: [Three patients with unrecognized orthostatic intolerance].
abstract: Three patients, men aged 20, 50 and 56 suffered from orthostatic intolerance and syncope for years, despite visits to many doctors. Medical history and cardiovascular reflex investigation revealed problems with the orthostatic blood pressure regulation, caused by initial orthostatic dysregulation, vasovagal syncope and pure autonomic failure, respectively. A structured medical history as well as blood pressure measurements in the supine and standing positions can reveal the diagnosis in many instances of syncope. After confirming the diagnosis, the first concern is a clear explanation of the underlying problems to the patient. Treatment with volume expansion should be considered.
authors.affiliation: Afd. Inwendige Geneeskunde, Academisch Medisch Centrum/Universiteit van Amsterdam.
authors.forename: N
authors.initials: N
authors.lastname: van Dijk
authors.forename: M P
authors.initials: MP
authors.lastname: Harms
authors.forename: W
authors.initials: W
authors.lastname: Wieling
mesh_terms: D000328:Adult; D006801:Humans; D008297:Male; D008875:Middle Aged; D011187:Posture; D012307:Risk Factors; D012791:Shy-Drager Syndrome / Q000150:complications* / Q000175:diagnosis* / Q000628:therapy; D013575:Syncope / Q000209:etiology*