Causes Of Orthostatic Hypotension For 2 Years?

Illustration of Causes Of Orthostatic Hypotension For 2 Years?
Illustration: Causes Of Orthostatic Hypotension For 2 Years?

Alodok, I continued to ask: are there any EKG and Holter with ECG. After the EKG test and Holter continued to the ECHO then the treadmill. At the Consul in July, after almost 2 years there was only a Consul without a solution, the doctor advised me to be referred to RSJ Harapan Kita Jkt for a tilt table test because there was no one in Bali. I answered, I need preparation, if it’s ready I ask for a reference. When the next consul asked for a referral, the doctor seemed confused and said he couldn’t, according to him it was from Neuro. There I got a lot of questions, is each doctor different? Because in Neuro I only have an EEG test, after the normal results are returned to the heart. What kind of poly valsalva maneuver test, I am confused, and what should I do next to get rid of despair. me. Please solution. Thank you

1 Answer:

Hi Komang,

Thank you for asking

Orthostatic hypotension (postural hypotension) occurs when blood pressure drops suddenly when you get up against gravity, for example when getting up from sitting or getting up from lying down. This condition can be felt by sufferers as a sensation of dizziness, lightheadedness, decreased consciousness, blurred vision, weakness, confusion, nausea, and even fainting. In mild conditions, orthostatic hypotension will improve within a few seconds. However, if the complaint continues for a long time, a more in-depth evaluation is needed to ascertain the causes and treatment to resolve it.

When the body moves against gravity, a lot of blood collects in the lower leg area as well as the stomach. This condition indirectly decreases the supply of blood that returns to the heart. Normally, there are cells called baroreceptors, which detect this, thus stimulating the heart to pump blood stronger and faster so that blood pressure doesn't drop. These cells also play a role in narrowing the diameter of blood vessels so that hypotension can be prevented. Failure of this compensatory mechanism can trigger orthostatic hypotension.

There are many triggers for orthostatic hypotension, ranging from dehydration, heart problems (eg bradycardia, heart valve disorders, heart failure, heart attacks), hormonal disorders (eg adrenal insufficiency, diabetes), nervous system disorders (eg Parkinson's disease, otonone neuropathy, Levi's dementia. body), postprandial hypotension (blood pressure drops after eating), and so on. As mentioned above, symptoms of orthostatic hypotension that last for a long time to limit the sufferer in activities need to be examined directly by a doctor or an internal medicine specialist so that it is further evaluated for possible causes. Furthermore, if necessary, the doctor will refer you to a specialist doctor who is appropriate to the suspicion of an underlying disease, for example a heart specialist, a neurologist, and so on.

There are many types of tests that can be done to detect possible causes of orthostatic hypotension, including:

Blood pressure monitor; the doctor will evaluate your blood pressure while sitting and standing then compare it, orthostatic hypotension sufferers will usually experience a reduction of at least 20 mmHg systolic blood pressure and at least 10 mmHg systolic blood pressure after standing Blood test; this examination is done to assess your overall health condition, including detecting the possibility of hypoglycemia and anemia which can both lower blood pressure. Electrocardiogram (EKG); This examination is done to monitor heart rhythm, heart structure, and possible problems with the blood supply to the heart muscle. If the EKG fails to detect a clear abnormality, a 24-hour EKG, also known as a Holter EKG, can be performed. Echocardiogram; This examination is performed using sound waves in order to assess the structure and function of the heart in general. Stress test (for example by treadmill or special medication); this examination will usually be combined with an EKG or echocardiogram so that abnormalities can be detected more accurately. Tilt table test (tilt table test); This test can help evaluate how the body responds to changes in position. While doing the test, the doctor will periodically check your blood pressure. Valsalva maneuver; This test can be done by taking a deep breath, holding for about 10 seconds, then continuing to exhale through your mouth like when you want to blow a balloon, while this test is done, the doctor will monitor your blood pressure and heart rate --- this manuever is generally done in an internal medicine specialist or a cardiologist, but other specialists can also do it. Indeed, often times, it is not an easy matter to ascertain where the exact cause of orthostatic hypotension comes from as you experience it. Therefore, the various examinations above are often combined so that handling can be carried out comprehensively.

Regarding your question, of course, each doctor has competences related to their field of knowledge. There are some specialistic domains that it is not right to be interfered with by other specialized domains, unless the conditions are very urgent. Therefore, we advise you not to give up. Consult directly with a heart specialist who previously treated you regarding the right treatment steps for you to take. If this doesn't satisfy you, don't hesitate to ask for a second opinion from another heart specialist.

Here are steps we can suggest to improve your complaint:

Drink a lot of 2 to 3 liters of water (especially water) per day Do not consume alcohol Avoid being in an environment that is too hot, including using clothes that are too hot Elevate your head while sleeping When you are about to get up from sitting or lying down, do it slowly If necessary , use compression stockings (ask your doctor for advice) Increase your intake of salt in your diet. Eat small portions but often and regularly Eat foods that contain balanced nutrition. Exercise regularly (as much as you can, but increase it slowly, both in terms of intensity, duration, and frequency. ) Don't smoke. Hope it helps.

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