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orthostatic syncope
Etiology:
- hypovolemia
- medications
- alcohol intoxication
- parkinsonism (less common)
- autonomic insufficiency
Clinical manifestations:
- rapid onset syncope after positional changes
- prodrome of lightheadedness common
- orthostasis:
- sustained reduction in systolic BP of >= 20 mm Hg or diastolic BP of >= 10 mm Hg within 3 minutes of assuming upright position
Management:
- volume expansion
- liberalization of salt intake
- medication reconciliation
- compression stockings
- education on postural changes
General
syncope
References
- Medical Knowledge Self Assessment Program (MKSAP) 18, 19.
American College of Physicians, Philadelphia 2018, 2021