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Publication

Inverted circadian variation of arterial pressure in a geriatric patient

Journal Contribution - Journal Article

Subtitle:an indicator of autonomic dysfunction

BACKGROUND: Orthostatic hypotension (OH) in geriatric patients frequently involves a component of autonomic failure (AF). The combination of OH with nocturnal hypertension (NHT) is indicative of AF, which is described as pure (PAF), when neurologic symptoms are absent, or as multisystem atrophy (MSA), when combined with motor disturbance (Parkinsonism or Parkinson disease).

CASE PRESENTATION: An 87-year-old man presented with long-lasting OH. He frequently fell, causing several fractures, and he developed heart failure. Blood pressure (BP) registration revealed a reversal of the day-night rhythm with NHT. An 18-FDG PET brain CT scan showed cerebellar hypometabolism, indicating MSA.

CONCLUSIONS: This case demonstrates the use of continuous BP registration in geriatric patients with OH for diagnosing NHT. It illustrates the usefulness of 18-FDG PET brain CT scan to specify the nature of the AF. The case also illustrates the difficulty of managing the combination of OH and NHT.

Journal: BMC Geriatrics
ISSN: 1471-2318
Issue: 1
Volume: 21
Publication year:2021
Keywords:18-FDG PET brain CT scan, Autonomic failure, Nocturnal hypertension, Orthostatic hypotension
BOF-keylabel:yes
IOF-keylabel:yes
BOF-publication weight:1
Authors:Regional
Authors from:Higher Education
Accessibility:Open