Orthostatic Intolerance and Coagulation Abnormalities: An Update
Orthostatic intolerance (OI) is a series of clinical symptoms that develop during long-term standing in the upright position, with clinical manifestations of frequent, recurrent, or persistent dizziness, fatigue, and heart palpitations with or without syncope. These symptoms are relieved after changing to the supine posture . OI includes vasovagal syncope (VVS), postural tachycardia syndrome, and autonomic nervous dysfunction . The pathogenesis underlying the vasovagal response (VVR) is not well-defined, but is considered to involve changes in the autonomic system and vascular dysfunction [2, 3].
The notion of OI co-morbidity and its importance in chronic fatigue syndrome has gained increasing attention [4, 5]. Recent studies have suggested that the blood coagulation system is activated during orthostatic stress [6, 7]. Induction of VVR leads to changes in blood coagulation factors indicating a hypercoagulable state . Similar changes in the coagulation system have been...
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