Syncope (“fainting”) is defined as a transient loss of consciousness due to reduced cerebral blood flow (1) It is a major clinical problem in the U.S. population. It is estimated that approximately 3% of emergency department visits and 2-6% of hospital admissions are for syncope (1), with more than 500,000 new patients experiencing syncope per year (2) and costing the health care system over $2...

coronary artery disease (CAD) and Parkinson’s Disease presented with episodic dizziness and left sided chest pressure that occurs when climbing one flight of stairs. Her symptoms resolve only after lying supine at the top of the stairs. Changes in vital signs taken at the bottom of and after climbing one flight of stairs were: systolic blood pressure (SBP): 132 to 82 mmHg; heart rate: 70 to 92 ...

Central hypothyroidism is commonly associated with impaired secretion of other anterior pituitary hormones, while isolated impairment of TRH-TSH-thyroid hormone axis was mostly identified in children and is a result of genetic mutations including TSH beta subunit gene or less commonly TRH receptor gene mutations. There are also a few reports of adult-onset isolated central hypothyroidism due to...

In multiple system atrophy (MSA), increased venous compliance with excessive venous pooling is assumed to be a major contributor to orthostatic hypotension (OH); however, venous compliance has never been assessed in MSA patients. We evaluated the severity and distribution of adrenergic, cardiovagal, and sudomotor failure in 11 patients with probable MSA, 14 age- and sex-matched control subjects...

PURPOSE The purpose of this study was to ascertain, in the context of an integrated health care delivery system, the association between a comprehensive list of drugs known to have potential QT liability and QT prolongation or shortening. METHODS By using a self-controlled crossover study with 59 467 subjects, we ascertained intra-individual change in log-linear regression-corrected QT (QTcre...

Abstract Background: Pregnancy is characterized by physiologic immunosuppression and the postpartum period often associated with rebound autoimmunity leading to unmasking of latent autoimmune disorders. Clinical Case: A thirty-one-year-old Caucasian female presented generalized fatigue, myalgias arthralgias that started three months after birth her first child. She was seen at a local hospital ...

Diagnosis of orthostatic hypotension (OH) is essential because the consequences include morbidity and mortality 1, 2. Prevalence is estimated to be as high as 6% in community-dwelling older adults and 65% in older person's care facilities 3. Diagnosis depends entirely on a drop in systolic or diastolic blood pressure (BP) from baseline. Baseline is typically estimated after a period of supine r...