[Hypotension--harmless or dangerous? The "orthostasis test" gives the answer]

Patients with non-specific symptoms that manifest when standing, are commonly seen in the doctor's office. The suspected diagnosis orthostatic dysregulation, can be established on the basis of a careful history, physical examination and a standing test. Frequent symptoms of orthostatic dysregulation are orthostatic hypotension, neurocardiogenic syncope and orthostatic intolerance. If a disorder of the autonomic nervous system is suspected, the need for further investigations is evaluated on an individual basis. The aim of such further diagnostic procedures is to differentiate between mild forms of autonomic disturbance that are unlikely to affect the patient's prognosis (mild orthostatic intolerance, neurocardiogenic syncope) and severe forms of autonomic failure, to identify the affected parts of the autonomic nervous system (partial or global autonomic failure) and, whenever necessary, to initiate appropriate treatment.