title: Initial orthostatic hypotension as a cause of recurrent syncope: a case report.
abstract: 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.
authors.affiliation: Department of Internal Medicine, Academic Medical Center, Cardiovascular Research Institute, Amsterdam, The Netherlands. w.wieling@amc.uva.nl
authors.forename: W
authors.initials: W
authors.lastname: Wieling
authors.forename: M P
authors.initials: MP
authors.lastname: Harms
authors.forename: R A
authors.initials: RA
authors.lastname: Kortz
authors.forename: M
authors.initials: M
authors.lastname: Linzer
mesh_terms: D000928:Antidepressive Agents / Q000009:adverse effects; D001794:Blood Pressure / Q000502:physiology; D001795:Blood Pressure Determination; D003866:Depressive Disorder / Q000150:complications / Q000188:drug therapy; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D007024:Hypotension, Orthostatic / Q000150:complications* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D013575:Syncope / Q000209:etiology* / Q000503:physiopathology
chemical_list: D000928:Antidepressive Agents