title: Arterial flow waveforms, vascular tone, and chronic fatigue: a case report.
abstract: We present the case of a patient with chronic fatigue secondary to Postural Orthostatic Tachycardia Syndrome (POTS) who had distinctive abnormalities in his arterial waveform morphology as assessed by pulse oximetry. Moreover, the patient's arterial waveform changed markedly from being supine to upright, suggesting that arterial flow patterns may be abnormal in our patient. Analysis of the waveform suggested a positional hypovolemia as the cause of his orthostatic intolerance. We review general aspects of arterial flow waveform analysis pertinent to health care providers and discuss the pathophysiology of POTS.
authors.affiliation: Anesthesia Service, Clement J. Zablocki VA Medical Center, 5000 West National Avenue, Milwaukee, WI 53295, USA; Department of Anesthesiology, Medical College of Wisconsin, 8701 Watertown Plank Rd, Milwaukee, WI 53226, USA.
authors.forename: M Tracy
authors.initials: MT
authors.lastname: Zundel
authors.affiliation: Department of Anesthesiology, Medical College of Wisconsin, 8701 Watertown Plank Rd, Milwaukee, WI 53226, USA.
authors.forename: Matthew
authors.initials: M
authors.lastname: Pattyn
authors.affiliation: Department of Neurology, Medical College of Wisconsin, 8701 Watertown Plank Rd, Milwaukee, WI 53226, USA.
authors.forename: Thomas C
authors.initials: TC
authors.lastname: Chelimsky
authors.affiliation: Tennessee Valley Healthcare System VA Medical Center, 1310 24(th) Avenue South, Nashville, TN 37212, USA; Department of Anesthesiology, Vanderbilt University, 1161 21(st) Avenue South, Nashville, TN 37232, USA. Electronic address: matthias.riess@vanderbilt.edu.
authors.forename: Matthias L
authors.initials: ML
authors.lastname: Riess
mesh_terms: D000328:Adult; D002908:Chronic Disease; D005221:Fatigue / Q000209:etiology / Q000503:physiopathology*; D006801:Humans; D020896:Hypovolemia / Q000503:physiopathology; D008297:Male; D010092:Oximetry / Q000379:methods; D054972:Postural Orthostatic Tachycardia Syndrome / Q000150:complications / Q000503:physiopathology*; D011187:Posture / Q000502:physiology; D058067:Wavelet Analysis
keywords: Dicrotic notch; Dysautonomia; POTS; Postural Orthostatic Tachycardia Syndrome; Pulse oximetry; Pulse wave travel time
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