On biomarkers: Patients with #Dysautonomia have preload failure. Invasive caridopulmonary testing or cardiac catheterization proves it. I just had a patient with post-Covid #POTS who had the tests done to rule out heart disease. She had no CAD, but did have preload failure. 1/🧵
Her excellent cardiologist @FudimMarat identified the problem and correctly diagnosed it. His findings were consistent with Dr. Systrom's study on preload failure. 2/🧵
onlinelibrary.wiley.com/doi/10.1086/68…
This patient was fortunate: she wasn't dismissed because her 2D cardiac echo & 24-hr Holter monitor were negative. Many patients with #Dysautonomia and #LongCovid are simply discounted as anxious or deconditioned when their routine cardiac & neurologic tests are unrevealing. 3/🧵
Physicians who are quick to label patients with #LongCovid, #Dysautonoima and #MECFS as "functional" or "medically unexplained" commonly employ these reasons: "routine tests are all normal" and "there is no biomarker." Clearly, they are wrong. 4/🧵
Invasive cardiac tests are far from ideal to confirm physiologic abnormalities but they are objective & reliable to serve as a model for simpler, non-invasive & cheaper tests that need to be developed for clinical use. #LongCoivd is not deconditioning! 5/5
onlinelibrary.wiley.com/doi/10.1086/68…
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