1. Advanced Search Article from the American Family Physician Journal.Category Health Conditions and Diseases hypotension...... Evaluation and Treatment of Orthostatic hypotension JOHN W. ENGSTROM, MD, andMICHAEL J. AMINOFF, MD University of California, San Francisco, School of http://www.aafp.org/afp/971001ap/engstrm.html

Advanced Search Articles Departments Patient Information ... Special Medical Reports Evaluation and Treatment of Orthostatic Hypotension JOHN W. ENGSTROM, M.D., and MICHAEL J. AMINOFF, M.D. University of California, San Francisco, School of Medicine San Francisco, California Orthostatic hypotension is defined as a decrease of at least 20 mm Hg in systolic blood pressure when an individual moves from a supine position to a standing position. Nonneurogenic causes of orthostatic hypotension are related to cardiac pump failure, reduced intravascular volume, venous pooling or a medication side effect. Neurogenic causes include both central and peripheral nervous system lesions. The diagnostic evaluation requires a systematic review of medications and coexisting medical conditions along with a neurologic examination to search for treatable factors that may be contributing to orthostatic hypotension. Specific testing of autonomic function is useful for detecting subclinical orthostatic hypotension or for monitoring autonomic function over a period of time. Treatment is directed at improving the patient's symptoms rather than achieving arbitrary blood pressure goals. Homeostatic control of blood pressure and heart rate requires frequent and rapid cardiovascular adjustments as an individual changes from supine to sitting and standing positions throughout the day. When these adjustments are not accomplished, orthostatic hypotension occurs. Some patients with severe orthostatic hypotension are severely incapacitated, and their families assume a significant burden in their care.

2. The Center For Pediatric Hypotension Information about the investigation, evaluation, and treatment of adolescents and children with syncope, orthostatic tachycardia, and other forms of chronic orthostatic intolerance including CFS. http://www.syncope.org/

syncope.org;http://www.nymc.edu/fhp/centers/syncope; syncope.org;http://www.nymc.edu/fhp/centers/syncope;

3. THE MERCK MANUAL, Sec. 16, Ch. 200, Orthostatic Hypotension And Syncope Orthostatic hypotension is not a specific disease but rather a manifestation of abnormal BP regulation due to various http://www.merck.com/pubs/mmanual/section16/chapter200/200a.htm

This Publication Is Searchable The Merck Manual of Diagnosis and Therapy Section 16. Cardiovascular Disorders Chapter 200. Orthostatic Hypotension And Syncope Topics Orthostatic Hypotension Syncope Orthostatic Hypotension Orthostatic hypotension is not a specific disease but rather a manifestation of abnormal BP regulation due to various causes. Etiology and Pathophysiology The gravitational stress of sudden standing normally causes pooling of blood in the venous capacitance vessels of the legs and trunk. The subsequent transient decrease in venous return and cardiac output results in reduced BP. Baroreceptors in the aortic arch and carotid bodies activate autonomic reflexes that rapidly normalize BP by causing a transient tachycardia. These changes reflect primarily the sympathetic mediated increase in catecholamine levels, which augments vasomotor tone of the capacitance vessels, increases heart rate and myocardial contractility, and thereby enhances cardiac output; arterial and venous vasoconstriction are mediated by similar mechanisms. Vagal inhibition also increases the heart rate. With continued standing, ADH secretion and activation of the renin-angiotensin-aldosterone system cause Na and water retention and expansion of the circulating blood volume. When afferent, central, or efferent portions of the

4. ORTHOSTATIC HYPOTENSION A look at what causes orthostatic hypotension as well as diagnosing, tests, treatment by way of nondrugs Category Health Conditions and Diseases hypotension......ORTHOSTATIC hypotension. Timothy C. Hain, MD. What Causes Orthostatic hypotension? Blood pressure is maintained by a combination of several things. http://www.tchain.com/otoneurology/disorders/medical/orthostatic.html

ORTHOSTATIC HYPOTENSION Timothy C. Hain, MD. Please read our Return to Index . Content last updated: 12/2002 Orthostasis means upright posture, and hypotension means low blood pressure. Thus, orthostatic hypotension consists of symptoms of dizziness, faintness or lightheadedness which appear only on standing, and which are caused by low blood pressure. Only rarely is spinning vertigo caused by orthostasis. Symptoms that often accompany orthostatic hypotension include chest pain, trouble holding the urine, impotence, and dry skin from loss of sweating. What Causes Orthostatic Hypotension ? Blood pressure is maintained by a combination of several things. The heart is the central pump, and a weak or irregular heart can cause orthostasis. Conditions such as arrhythmia, heart failure, deconditioning, and pregnancy are examples where the heart may not be up to the task of providing an adequate blood pressure. The heart pumps blood, and if there is too little blood volume (anemia, dehydration, dialysis), the pressure drops. The blood vessels in the body also can squeeze (constrict) to raise blood pressure, and if this action is paralyzed, blood pressure may fall. Numerous medications affect blood vessels including most of the medications used for blood pressure, and many of the medications used in psychiatry and for anginal heart pain. Heat, such as a hot shower or from a fever can also dilate blood vessels and cause orthostasis. The nervous system senses and responds to regulate blood pressure. If something is wrong in this control system, blood pressure may fluctuate.

5. Spontaneous Intracranial Hypotension A discussion about this disorder, its features, causes, diagnosis and treatment. http://medmic02.wnmeds.ac.nz/groups/rmo/headache/headache16.html

Spontaneous intracranial hypotension Spontaneous intracranial hypotension may present quite suddenly or more gradually. Headache may involve the whole head, or be frontal or occipital. It worsens in the erect position with improvement on lying down. It is worsened by jugular venous compression or the Valsava manoeuvre. Other features include: Neck stiffness tinnitus faintness photophobia nausea and vomiting Causes The cause is often unclear, although cases have been attributed to tears in nerve root sleeves resulting from a sneeze or strain. A similar headache may occur after lumbar puncture Diagnosis Lumbar puncture should be performed. The pressure is usually less than 60 mm of CSF. The protein may be elevated, and red cells or xanthochromia may be present. Isotope cisternography shows a rapid decrease of activity in the subarachnoid space, and a specific site of CSF leak may be demonstrated. Treatment bed rest epidural blood patch intrathecal saline infusion oral caffeine surgical repair of any meningeal defect that is found. E-mail comments or criticisms to: Dr Graeme Hammond Tooke Last modified: 3 Jan 1999

6. MEDLINEplus Medical Encyclopedia: Blood Pressure - Low Medline Health information looks at this disorder. An overview and indepth look at the causes and Category Health Conditions and Diseases hypotension...... Alternative names Return to top hypotension; Low blood pressure. DefinitionReturn to top An abnormal condition in which the blood http://www.nlm.nih.gov/medlineplus/ency/article/003083.htm

Skip navigation Medical Encyclopedia Other encyclopedia topics: A-Ag Ah-Ap Aq-Az B-Bk ... Z Blood pressure - low Contents of this page: Illustrations Alternative names Definition Considerations ... What to expect at your health care provider's office Illustrations Effects of age on blood pressure Alternative names Return to top Hypotension; Low blood pressure Definition Return to top An abnormal condition in which the blood pressure is lower than 90/60 or is low enough to cause symptoms or interfere with well-being. Considerations Return to top The blood pressure is normally above 90/60 mmHg (millimeters of mercury ). When the blood pressure is too low there is inadequate blood flow to the heart, brain, and other vital organs. Borderline low blood pressure for one person may be normal for another. The most important factor is how the blood pressure changes from the baseline or normal condition. A fall of 20 mmHg or more from a person's baseline is considered very significant. Common Causes Return to top drugs including anesthesia, antianxiety agents, antihypertensives, calcium channel blockers, diuretics, general anesthetics, antiarrhythmics, monoamine oxidase inhibitors, narcotic analgesics , tranquilizers, vasodilators, alcohol dehydration heart failure, heart attack or changes in heart rhythm

7. Hypotension Other factors which increase the risk of hypotension include lack of antenatal steroids, 2 large patent ductus http://www.cs.nsw.gov.au/rpa/neonatal/html/newprot/hypotefn.htm

Department of Neonatal Medicine Protocol Book Royal Prince Alfred Hospital Hypotension Introduction: Blood pressure (BP) is the product of blood flow and vascular resistance. Normal BP is difficult to define in preterm babies, a group who, by definition, are not normal. Watkins et al defined the 10th centile for mean BP within the first 24 hours according to birth weight. Birth Weight 10th centile for mean BP 500-750 grams 26 mmHg 750-1000 grams 28 mmHg 1000-1250 grams 29 mmHg 1250-1500 grams 30 mmHg From this a useful "rule of thumb" can be derived that mean BP should be maintained above the gestation in weeks. Incidence and risk factors: Other factors which increase the risk of hypotension include lack of antenatal steroids, large patent ductus arteriosus , higher pressure ventilation. Risk of hypotension reduces with increasing postnatal age. Consequences: Hypotension has been associated with poor outcomes, particularly intraventricular haemorrhage and periventricular leukomalacia. Diagnosis: BP is used in neonatology as a marker of systemic perfusion. However BP correlates only weakly with cardiac output and babies can have low BP and normal cardiac output and normal BP and low cardiac output.

8. Orthostatic Hypotension Information:CWRU Autonomic Lab Instructions for patients with orthostatic hypotension Orthostatic hypotension means that when you are standing ("static") upright ("ortho"), your blood pressure ("tension") falls ("hypo"), and causes you to become dizzy or even pass out. http://mediswww.meds.cwru.edu/dept/neurology/autonomic/orthostatic.html

Instructions for patients with orthostatic hypotension Orthostatic hypotension means that when you are standing ("static") upright ("ortho"), your blood pressure ("tension") falls ("hypo"), and causes you to become dizzy or even pass out. There are several causes for this, including not taking enough fluids and salts, some medications (for example, the tricyclic antidepressants and the anti-hypertensives, of course), and some hormonal problems. However, much of the time, the problem is due to the fact that the nerves are not telling the vessels to close down when you stand up. You may not realize this, but whenever you stand, the blood vessels in the rest of the body must close down, so that blood can continue flowing to the brain. The nerves (specifically, the autonomic nerves) are responsible for this. If they are not working, as sometimes happens in diabetes or in Parkinson's disease, the vessels do not close properly, and result in orthostatic hypotension. First, a diagnosis must be obtained, to understand the origin and severity of the problem. This will usually include autonomic testing, including blood pressure testing, perhaps some bloodwork, and sometimes some imaging of the brain. Second, some basic simple measures will help greatly:

9. THE MERCK MANUAL OF GERIATRICS, Sec. 11, Ch. 86, Hypotension stimuli progressively declines, and the risk of hypotension increases. Baroreflex function is most impaired in http://www.merck.com/pubs/mm_geriatrics/sec11/ch86.htm

Section 11. Cardiovascular Disorders this section includes Chapter 83. Aging and the Cardiovascular System Chapter 84. Diagnostic Evaluation Chapter 85. Hypertension Chapter 86. Hypotension ... Chapter 96. Cardiovascular Surgery and Percutaneous Interventional Techniques Chapter 86. Hypotension Contributor: Lewis Lipsitz Subnormal arterial blood pressure. Baroreflex mechanisms regulate systemic blood pressure by increasing or decreasing heart rate and vascular resistance in response to transient decreases or increases in arterial pressure. With age, the baroreflex response to hypertensive and hypotensive stimuli progressively declines, and the risk of hypotension increases. Baroreflex function is most impaired in elderly patients with hypertension. Signs of impairment include increased blood pressure lability in response to daily activities and hypotension in response to stimuli that lower arterial pressure, particularly drugs. The diminished baroreflex response may be caused partly by arterial stiffening due to atherosclerosis, which results in dampening of baroreceptor stretch and relaxation during changes in arterial pressure. Reduced adrenergic responsiveness by the aged heart and vasculature may diminish baroreflex-mediated cardioacceleration and vasoconstriction in response to hypotensive stimuli. These changes become clinically significant when common hypotensive stresses, such as postural changes, can no longer be rapidly or completely offset by compensatory increases in heart rate or in vascular resistance.

10. Johns Hopkins Children's Center John Hopkins Hospital looks at this order indepth as to what it is, causes of symptoms, how it is diagnosed and treatment. Offered are helpful hints and extensive diet information. http://ww2.med.jhu.edu/peds/cfs.html

Hopkins Now Primary Site for I.D. and Treatment of Child Abuse As in all large city hospitals, the pediatric emergency department at Johns Hopkins Children’s Center cares for the most ill and traumatized children in its surrounding neighborhoods. Among the most tragic are those injured by their parents or other trusted adults. Hundreds of suspected-abuse victims end up in Hopkins’ emergency rooms and clinics every year. Mar 19, 2003 Advice for Helping Children Cope with News of War and Terrorism Mar 18, 2003 In Vitro Fertilization May Be Linked to Bladder Defects Mar 10, 2003 Chemical in Soy Alters Reproductive Organs in Male Rats Mar 3, 2003 MIX 106 FM Radiothon Total: $1,030,582 Johns Hopkins Medicine Site design by Aline Lin

11. For Parents Of Sick And Worn-Out Children Deals with pediatric chronic fatigue syndrome, neurally mediated hypotension, fibromyalgia and other related syndromes. By Frank Albrecht, PhD. http://www.bluecrab.org/health/sickids/sickids.htm

12. Www.nlm.nih.gov/cgi/mesh/2K/MB_cgi?term=Hypotension http://www.nlm.nih.gov/cgi/mesh/2K/MB_cgi?term=Hypotension

13. THE MERCK MANUAL, Sec. 16, Ch. 200, Orthostatic Hypotension And Syncope An article about orthostatic hypotension and syncope. http://www.merck.com/pubs/mmanual/section16/chapter200/200b.htm

This Publication Is Searchable The Merck Manual of Diagnosis and Therapy Section 16. Cardiovascular Disorders Chapter 200. Orthostatic Hypotension And Syncope Topics Orthostatic Hypotension Syncope Syncope (Fainting) A sudden brief loss of consciousness, with loss of postural tone. Etiology and Pathophysiology Bradyarrhythmias (especially those with abrupt onset) can cause syncope. These include the sick sinus syndrome, with or without tachyarrhythmias, and high-grade atrioventricular block. Although bradyarrhythmias occur at all ages, they are most frequent in the elderly and are usually due to ischemia or fibrosis of the conduction system. Digitalis, -blockers (including ophthalmic -blockers), Ca blockers, and other drugs may also cause bradyarrhythmias. Supraventricular or ventricular tachyarrhythmias that cause syncope may be related to ischemia, heart failure, drug toxicity (quinidine syncope is the best known), electrolyte abnormalities, preexcitation, and other disorders. Syncope with chest pain of myocardial ischemia is usually related to arrhythmia or heart block but rarely may reflect substantial ischemic ventricular dysfunction with a reduced cardiac output. Syncope can be due to atrioventricular block in acute inferior MI. Many other mechanisms, often in combination, may limit cardiac output, such as a decrease in systemic BP due to peripheral vasodilation, decreased venous return to the heart, hypovolemia, and cardiac outflow obstruction. Diminished cerebral perfusion may also be caused by cerebral vasoconstriction, eg, induced by hypocapnia.

14. Teenagers With Chronic Illnesses For teenagers going through chronic illnesses, mainly hypotension and chronic fatigue syndrome. This site helps them to connect and relate to each other. http://hometown.aol.com/dazzlnstrz/myhomepage/

htmlAdWH('7005340', '120', '30'); htmlAdWH('7002028', '234', '60'); Main Create Edit Help Hello Everyone!! Teenagers with chronic illnesses site has been moved to a new address!! Please click on the link below! Teenagers with chronic illnesses NEW SITE!:) **AOL just didn't have everything that i wanted to create a website with, so i moved it to another website!! It's pretty much the same, just at a new location! Don't worry i haven't totally disappeard!:) page created with Easy Designer

15. The Pediatric Network For Chronic Fatigue Syndrome, Fibromyalgia, And Orthostati Resources for all concerned with pediatric chronic fatigue syndrome, fibromyalgia, neurally mediated hypotension, postural orthostatic tachycardia syndrome, and related conditions. http://www.pediatricnetwork.org

for Chronic Fatigue Syndrome, Fibromyalgia, and Orthostatic Intolerance Home News Forum Contribute ... Help Please Support Our Work: Donate : Learn how you can contribute through direct gifts, shopping at Amazon.com, or applying for a VISA card Shop Amazon.com through our store . Explore products like these: Search Now: Forum Hot Topics Stay Connected! Welcome to this network for parents, youth, and professionals concerned with chronic fatigue syndrome, fibromyalgia, and orthostatic intolerance. See our live chat announcements below for opportunities to "talk" with youth or parents about your medical, educational, and coping questions. Share our brochure to help others become a part of this network. You will need the free Acrobat Reader software to view and print the brochure Receive our monthly newsletter by registering and posting in the forum . We will e-mail the newsletter to the address you provide during forum registration. Participate in forum discussions to hear about others' medical and school experiences, and to learn of opportunities to volunteer, participate in studies, or meet other families. Would you like more people to know about pediatric CFS, FM, and OI?

16. Orthostatic Hypotension Information:CWRU Autonomic Lab This article discusses orthostatic hypotension with a brief description and details on diagnosing, tips to assist the patient, diet, salt, and medications. http://mediswww.cwru.edu/dept/neurology/autonomic/orthostatic.html

Instructions for patients with orthostatic hypotension Orthostatic hypotension means that when you are standing ("static") upright ("ortho"), your blood pressure ("tension") falls ("hypo"), and causes you to become dizzy or even pass out. There are several causes for this, including not taking enough fluids and salts, some medications (for example, the tricyclic antidepressants and the anti-hypertensives, of course), and some hormonal problems. However, much of the time, the problem is due to the fact that the nerves are not telling the vessels to close down when you stand up. You may not realize this, but whenever you stand, the blood vessels in the rest of the body must close down, so that blood can continue flowing to the brain. The nerves (specifically, the autonomic nerves) are responsible for this. If they are not working, as sometimes happens in diabetes or in Parkinson's disease, the vessels do not close properly, and result in orthostatic hypotension. First, a diagnosis must be obtained, to understand the origin and severity of the problem. This will usually include autonomic testing, including blood pressure testing, perhaps some bloodwork, and sometimes some imaging of the brain. Second, some basic simple measures will help greatly:

17. On Health With WebMD A discussion of hypotension and its symptoms. http://www.onhealth.com/conditions/resource/conditions/item,46337.asp

18. Effets Secondaires Des Substances : HYPOTENSION ARTERIELLE Effets Secondaires des Substances hypotension ARTERIELLE. ACEFYLLINE PIPERAZINE;ACEPROMAZINE; ACEPROMETAZINE; ACETANILIDE; ACETYLCHOLINE CHLORURE; http://www.biam2.org/www/SubEIIMCHYPOTENSION_ARTERIELLE.html

Effets Secondaires des Substances : HYPOTENSION ARTERIELLE ACEFYLLINE PIPERAZINE ACEPROMAZINE ACEPROMETAZINE ACETANILIDE ... ZIDOVUDINE

19. Lycos With WebMD Takes a look at hypotension and accompanying conditions, symptoms and treatment. http://webmd.lycos.com/content/dmk/dmk_article_1458039

20. Effets Secondaires Des Substances : HYPOTENSION ORTHOSTATIQUE Effets Secondaires des Substances hypotension ORTHOSTATIQUE. ACEBUTOLOLCHLORHYDRATE; ACETAZOLAMIDE; ACETAZOLAMIDE SODIQUE; ALFUZOSINE CHLORHYDRATE; http://www.biam2.org/www/SubEIIMCHYPOTENSION_ORTHOSTATIQUE.html

Effets Secondaires des Substances : HYPOTENSION ORTHOSTATIQUE ACEBUTOLOL CHLORHYDRATE ACETAZOLAMIDE ACETAZOLAMIDE SODIQUE ALFUZOSINE CHLORHYDRATE ... ZUCLOPENTHIXOL DICHLORHYDRATE

A  B  C  D  E  F  G  H  I  J  K  L  M  N  O  P  Q  R  S  T  U  V  W  X  Y  Z

Page 1     1-20 of 107    1  | 2  | 3  | 4  | 5  | 6  | Next 20