Thread by @TheEDSociety

October is #DysautonomiaAwarenessMonth. Today we are looking at some of the known causes of autonomic dysfunction, and how it is investigated. ⁠[THREAD]

The cause(s) of #autonomicdysfunction in #EDS and #HSD remains unclear. However, some possible causes include: ⁠
🧍🏾‍♀️Increased blood pooling (e.g., in the legs when standing or around the gut after eating) ⁠
🩸Low circulating blood volume ⁠

💊 Medications with side effects that trigger or make problems worse, auto-immunity (immune responses to the person’s own body) ⁠
😷 Too much #histamine in the body (related to #allergy)
⚫️ Rarely, brainstem or spinal cord restriction⁠

🩺 For a doctor, initially defining a patient’s history is important: ⁠
⁠
⚫️ Symptoms⁠
⚫️ Triggers⁠
⚫️ Modifying factors⁠
⚫️ Impact on daily life⁠
⚫️ Possible causes⁠
⚫️ Family history⁠

Many of the common cardiovascular autonomic symptoms relate to changes in posture. They occur when changing from a lying or sitting to a standing position, or with maintaining upright posture, and are improved but not always completely relieved by sitting or lying down.⁠

The history may reveal things that trigger or exacerbate these symptoms — heat, prolonged standing, alcohol, dehydration, having a cold, etc. A detailed examination is always warranted. ⁠

Other common causes of low blood pressure or fast heart rate should be considered, like medications, dehydration, and deconditioning. ⁠

Formal evaluation of cardiovascular autonomic dysfunction is often made with a tilt table test usually done by an autonomic neurologist or electrophysiologist, however, a standard approach is a sitting-to-standing pulse and blood pressure test in the clinic. #Dysautonomia #POTS