Cardiology meets neurology: clinical presentation and management of patients with primary neurogenic disorders and orthostatic intolerance.

Abstract

Patients with primary neurogenic disorders such as pure autonomic failure or multiple system atrophy may initially present with cardiocirculatory symptoms such as orthostatic intolerance or fluctuations in heart rate with symptomatic tachycardia. It is therefore clinically important to identify such patients since circulatory manifestations are only one of aseries of symptoms resulting from autonomic dysfunction in various organ systems. These patients require amultimodal diagnostic and therapeutic approach and should undergo extensive evaluation in aspecialized autonomic nervous system (ANS) outpatient unit. Based on aclinical case presentation, the current review summarizes the diagnostic and therapeutic approach to key cardiovascular symptoms of primary autonomic disorders and their neurological work-up in aspecialized autonomic function laboratory.