[Autonomic profile and cardiovascular symptoms].
The autonomic nervous system controls all body functions. Dysregulation of this system, called dysautonomia, is responsible of polymorphic functional symptoms. Its exploration can reveal abnormalities which explains the clinical symptoms. The objective of this work is to try to find a connection between functional signs, mainly cardio-vascular and autonomic abnormalities. We also consider the autonomic profile of a group of patients with primary hypertension.


METHODS
Patients with functional symptoms and normal clinical and paraclinical examinations underwent autonomic profile study. The following tests were performed: deep breathing, hand grip, echo stress, Valsalva maneuver and tilt test.


RESULTS
Two hundred and eighty four patients were included in this study, females 70%, mean age 44 years (extremes 9 and 81). In this group of patients, the main autonomic syndromes found were: orthostatic hypotension, 88 patients in whom the alpha peripheral sympathetic activity is decreased and the vagal one is increased, postural orthostatic tachycardia syndrome (POTS), 123 patients who describe orthostatic symptoms and in whom beta sympathetic activity is high, the neurocardiogenic syncope, four patients in whom vagal activity is high, and the baro-receptor abnormality (115 patients) of variable degree. In patients with primary hypertension (137), the alpha sympathetic activity is high (mean increase of blood pressure of 38.5%), meanwhile the vagal one is low. Twelve patients having diabetes showed a low vagal activity, (mean EKG RR variation of 8%). The treatment, depending on the autonomic abnormality (hygienodietetic measures, éthyléphrine, fludrocortisone, phenobarbital, clonidine, maproptyline, sérotonine recapture inhibitor) showed an improvement in the functional state of the patients.


CONCLUSIONS
Autonomic profile study helps to explain the causes of symptoms described by the patients whose clinical and conventional paraclinical examinations are normal.
Service de cardiologie A, CHU Ibn-Sina, Rabat, Maroc.
I
I
El Honsali
H
H
Benjelloun
C L
CL
Coghlan
M
M
Benomar
D000293:Adolescent; D000328:Adult; D000368:Aged; D001342:Autonomic Nervous System Diseases / Q000209:etiology*; D001794:Blood Pressure; D002318:Cardiovascular Diseases / Q000150:complications*; D002648:Child; D048909:Diabetes Complications; D004562:Electrocardiography; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications*; D007024:Hypotension, Orthostatic / Q000209:etiology; D008297:Male; D008875:Middle Aged; D013575:Syncope; D013610:Tachycardia / Q000150:complications