自主神经失调症和体位性正位性心动过速综合征:Dysautonomia: How to Diagnose and Treat》的批判性分析。

IF 2 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS
Michael I Weintraub, Nicholas L DePace, Ramona Munoz, Karolina Kaczmarski, Ron Manno, Joseph Colombo
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引用次数: 0

摘要

相当多的医生不清楚自律神经失调症和自律神经系统(特别是副交感神经系统和交感神经系统)失衡的大量临床表现。主要障碍是无法确定作用机制以及多系统功能障碍,并且缺乏明确的测试。自主神经失调症是人体交感神经和副交感神经的病理生理功能失调,临床表现为心率(心动过速/心动过缓)、呼吸模式改变、血压(高血压/高血脂)、出汗、消化、晕厥等功能改变。这些症状由于相对缺乏特异性,导致专科医生漏诊。我们目前对患者的分析表明,由于上述原因,诊断延误、误诊和慢性综合征的发展非常严重。我们证明,随着体位和呼吸的变化监测心率和血压可以在没有正立压力的情况下方便快捷地进行,并能显示交感神经衰退、胆碱能过度以及心动过速、血压随体位下降等实体。这种分析只需不到一个小时的时间,无需注射或服药,因此能更快地告知心脏病学家/神经病学家正确的诊断。我们将尝试揭开这些问题的神秘面纱,以便临床医生和科学界更好地了解这种疾病,在鉴别诊断过程中更早地考虑自律神经失调的诊断,更早地开始治疗方法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Dysautonomia and Postural Orthostatic Tachycardia Syndrome: A Critical Analysis of Dysautonomia: How to Diagnose and Treat.

A significant number of physicians are unclear of the vast clinical manifestations of dysautonomia and imbalance of the autonomic nervous system, specifically the parasympathetic and sympathetic nervous systems. The major obstacle has been an inability to determine the mechanism of action as well as multisystem dysfunction and a lack of clear-cut testing. Dysautonomia, a pathophysiological malfunction of the sympathetic and parasympathetic nerves in our bodies, can present as altered clinical functions of heart rate (tachycardia/bradycardia), altered breathing patterns, blood pressure (hypertension/hypotension), sweating, digestion, syncope, etc. These symptoms have caused specialists to miss this diagnosis because of relative nonspecificity. Our current analysis of patients demonstrates significant delays in diagnosis, misdiagnosis, and the development of chronic syndromes because of the above. We demonstrate that monitoring of heart rate and blood pressure with changes in position and respiration can be easily and quickly performed without orthostatic stress and can demonstrate the entities of sympathetic withdrawal, cholinergic excessive aspects as well as tachycardia, blood pressure dips with posture, etc. This analysis takes less than an hour without the need for injections or medication, thus more quickly informing the cardiologist/neurologist of the correct diagnosis. We will attempt to demystify these issues so that clinicians and the scientific community will have a better understanding of this entity and consider a diagnosis of dysautonomia earlier in the differential diagnostic process and start treatment approaches sooner.

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来源期刊
Cardiology in Review
Cardiology in Review CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
4.60
自引率
0.00%
发文量
76
审稿时长
>12 weeks
期刊介绍: The mission of Cardiology in Review is to publish reviews on topics of current interest in cardiology that will foster increased understanding of the pathogenesis, diagnosis, clinical course, prevention, and treatment of cardiovascular disorders. Articles of the highest quality are written by authorities in the field and published promptly in a readable format with visual appeal
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