What is the pathophysiology of orthostatic syncope?

Updated: Jan 13, 2017
  • Author: Rumm Morag, MD, FACEP; Chief Editor: Erik D Schraga, MD  more...
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Answer

Dehydration and decreased intravascular volume contribute to orthostasis. Orthostatic syncope describes a causative relation between orthostatic hypotension and syncope. Orthostatic hypotension increases in prevalence with age as a blunted baroreceptor response results in failure of compensatory cardioacceleration. In elderly patients, 45% of these cases are related to medications. Limited evidence suggests that polydipsia may reduce recurrences. Orthostasis is a common cause of syncope and tends to be recurrent. Bedside orthostatics cannot exclude this as an etiology; if it is suspected, patients should be referred to a primary care provider for outpatient tilt-table testing.


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