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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...

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Autores principales: Lieten, Siddhartha, Debain, Aziz, Bravenboer, Bert, Mets, Tony
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2021
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.
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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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