Skip to main content

Sample Case Studies

  • Chapter
  • First Online:
  • 1853 Accesses

Abstract

In this chapter, we discuss some common sample case studies, including hypertension with depression, unexplained dizziness, cardiovascular autonomic neuropathy (CAN), sleep apnea, atrial fibrillation, cardiac pathology, diabetes, and depression. It is important to remember that the main goal of autonomic assessment and therapy is not to cure disease. While that may happen, the goal is to slow the progression of autonomic dysfunction and to minimize morbidity and mortality risk. This enables the physician to be more aggressive towards the primary disease and to promote and maintain wellness once the primary disease is controlled. For example, autonomic assessment may not cure heart disease, arrhythmia, COPD, diabetes, or Parkinson’s disease; treating documented autonomic dysfunction will lead to relief from dizziness, depression, secondary hypertension, sleep disorder, etc. This leads to reduced medication load, reducing the potential for conflicting or confounding therapies. This also leads to reduced hospitalization and helps to promote reduced healthcare costs for both the patient and the nation while improving outcomes.

This is a preview of subscription content, log in via an institution.

Buying options

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   149.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   199.00
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD   219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

Notes

  1. 1.

    See “Possible Therapy Options.”

  2. 2.

    ALA

  3. 3.

    Carvedilol

  4. 4.

    Pamelor

  5. 5.

    Proamatine

  6. 6.

    See the trend plot (Fig. 30.10, middle graph). Note that the peak sympathetic (red) response to standing (section “F”) is comparable to that for Valsalva (section “D”). The reason why this does not show on the average is that the time duration of the stand is 300 s and that for Valsalva is 90 s. So the stand peaks often are averaged out.

References

  1. Arora RR, Bulgarelli RJ, Ghosh-Dastidar S, Colombo J. Autonomic mechanisms and therapeutic implications of postural diabetic cardiovascular abnormalities. J Diabetes Sci Technol. 2008;2(4):568–71.

    Article  Google Scholar 

  2. Vinik AI, Murray GL. Autonomic neuropathy is treatable. US Endocrinol. 2008;2:82–4.

    Google Scholar 

  3. Arora RR, Iffrig K, Aysin E, Aysin B, Colombo J. Resting sympathetic/parasympathetic imbalance effects outcomes in geriatric heart failure patients. New Orleans: American College of Cardiology; 2007. 56th Annual Scientific Session.

    Google Scholar 

  4. Arora RR, Iffrig K, Colombo J. Geriatric female longevity associated with elevated parasympathetic tone. Can the same be affected in geriatric males? Presented at the American Autonomic Society’s 17th International Symposium on the Autonomic Nervous System, Rio Grande. Accessed 1–4 Nov 2006.

    Google Scholar 

  5. Waheed A, Ali MA, Jurivich DA, et al. Gender differences in longevity and autonomic function. Presented at the Geriatric Medicine Society Meeting, Chicago. Accessed 3–7 May 2006.

    Google Scholar 

  6. Arora RR, Iffrig K, Aysin E, Aysin B, Colombo J. Geriatric gender differences in parasympathetic tone may modify treatment of geriatric men and women. New Orleans: American College of Cardiology; 2007. 56th Annual Scientific Session.

    Google Scholar 

  7. Pereira E, Baker S, Bulgarelli RJ, Murray G, Arora RR, Colombo J. Gender differences in longevity and sympathovagal balance. Presented at the Cleveland Clinic Heart-Brain Summit, Cleveland Clinic Lou Ruvo Center for Brain Health, Las Vegas. Accessed 23–24 Sept 2010.

    Google Scholar 

  8. Umetani K, Singer DH, McCraty R, Atkinson M. Twenty-four hour time domain heart rate variability and heart rate: relations to age and gender over nine decades. JACC. 1998;31(3):593–601.

    Article  CAS  PubMed  Google Scholar 

  9. Litchman JH, Bigger Jr JT, Blumenthal JA, et al. Depression and coronary heart disease recommendations for screening, referral, and treatment: a science advisory from the American Heart Association Prevention Committee of the Council on Cardiovascular Nursing, Council on Clinical Cardiology, Council on Epidemiology and Prevention, and Interdisciplinary Council on Quality of Care and Outcomes Research: endorsed by the American Psychiatric Association. Circulation. 2008;118:1768–75.

    Article  Google Scholar 

  10. Sandroni P, Opfer-Gehrking TL, Singer W, Low PA. Pyridostigmine for treatment of neurogenic orthostatic hypotension: a follow up survey study. Clin Auton Res. 2005;15:51–3.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

Copyright information

© 2015 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Colombo, J., Arora, R., DePace, N.L., Vinik, A.I. (2015). Sample Case Studies. In: Clinical Autonomic Dysfunction. Springer, Cham. https://doi.org/10.1007/978-3-319-07371-2_30

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-07371-2_30

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-07370-5

  • Online ISBN: 978-3-319-07371-2

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics