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Inverted circadian variation of arterial pressure in a geriatric patient: an indicator of autonomic dysfunction
BACKGROUND: Orthostatic hypotension (OH) in geriatric patients frequently involves a component of autonomic failure (AF). The combination of OH with nocturnal hypertension (NHT) is indicative of AF, which is described as pure (PAF), when neurologic symptoms are absent, or as multisystem atrophy (MSA...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7919995/ https://www.ncbi.nlm.nih.gov/pubmed/33648443 http://dx.doi.org/10.1186/s12877-021-02059-3 |
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author | Lieten, Siddhartha Debain, Aziz Bravenboer, Bert Mets, Tony |
author_facet | Lieten, Siddhartha Debain, Aziz Bravenboer, Bert Mets, Tony |
author_sort | Lieten, Siddhartha |
collection | PubMed |
description | BACKGROUND: Orthostatic hypotension (OH) in geriatric patients frequently involves a component of autonomic failure (AF). The combination of OH with nocturnal hypertension (NHT) is indicative of AF, which is described as pure (PAF), when neurologic symptoms are absent, or as multisystem atrophy (MSA), when combined with motor disturbance (Parkinsonism or Parkinson disease). CASE PRESENTATION: An 87-year-old man presented with long-lasting OH. He frequently fell, causing several fractures, and he developed heart failure. Blood pressure (BP) registration revealed a reversal of the day-night rhythm with NHT. An 18-FDG PET brain CT scan showed cerebellar hypometabolism, indicating MSA. CONCLUSIONS: This case demonstrates the use of continuous BP registration in geriatric patients with OH for diagnosing NHT. It illustrates the usefulness of 18-FDG PET brain CT scan to specify the nature of the AF. The case also illustrates the difficulty of managing the combination of OH and NHT. |
format | Online Article Text |
id | pubmed-7919995 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-79199952021-03-02 Inverted circadian variation of arterial pressure in a geriatric patient: an indicator of autonomic dysfunction Lieten, Siddhartha Debain, Aziz Bravenboer, Bert Mets, Tony BMC Geriatr Case Report BACKGROUND: Orthostatic hypotension (OH) in geriatric patients frequently involves a component of autonomic failure (AF). The combination of OH with nocturnal hypertension (NHT) is indicative of AF, which is described as pure (PAF), when neurologic symptoms are absent, or as multisystem atrophy (MSA), when combined with motor disturbance (Parkinsonism or Parkinson disease). CASE PRESENTATION: An 87-year-old man presented with long-lasting OH. He frequently fell, causing several fractures, and he developed heart failure. Blood pressure (BP) registration revealed a reversal of the day-night rhythm with NHT. An 18-FDG PET brain CT scan showed cerebellar hypometabolism, indicating MSA. CONCLUSIONS: This case demonstrates the use of continuous BP registration in geriatric patients with OH for diagnosing NHT. It illustrates the usefulness of 18-FDG PET brain CT scan to specify the nature of the AF. The case also illustrates the difficulty of managing the combination of OH and NHT. BioMed Central 2021-03-01 /pmc/articles/PMC7919995/ /pubmed/33648443 http://dx.doi.org/10.1186/s12877-021-02059-3 Text en © The Author(s) 2021 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Case Report Lieten, Siddhartha Debain, Aziz Bravenboer, Bert Mets, Tony Inverted circadian variation of arterial pressure in a geriatric patient: an indicator of autonomic dysfunction |
title | Inverted circadian variation of arterial pressure in a geriatric patient: an indicator of autonomic dysfunction |
title_full | Inverted circadian variation of arterial pressure in a geriatric patient: an indicator of autonomic dysfunction |
title_fullStr | Inverted circadian variation of arterial pressure in a geriatric patient: an indicator of autonomic dysfunction |
title_full_unstemmed | Inverted circadian variation of arterial pressure in a geriatric patient: an indicator of autonomic dysfunction |
title_short | Inverted circadian variation of arterial pressure in a geriatric patient: an indicator of autonomic dysfunction |
title_sort | inverted circadian variation of arterial pressure in a geriatric patient: an indicator of autonomic dysfunction |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7919995/ https://www.ncbi.nlm.nih.gov/pubmed/33648443 http://dx.doi.org/10.1186/s12877-021-02059-3 |
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