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Diagnostic Tools to Assess Dysfunction of Autonomic Control of the Heart

Richard Sutton1

  • 1Cardiac Dept., Hammersmith Hospital Campus of National Heart & Lung Institute, Imperial College, London, United Kingdom.

Journal of Atrial Fibrillation
|October 7, 2020
PubMed

Insights

A detailed clinical history is crucial for diagnosing heart autonomic dysfunction, often avoiding extensive testing. This paper guides appropriate diagnostic tests when history is insufficient.

Area of Science:

  • Cardiology
  • Autonomic Neuroscience

Background:

  • Autonomic control of the heart is vital for cardiovascular homeostasis.
  • Dysfunction can lead to syncope and other serious events.
  • Accurate diagnosis relies heavily on patient history.

Purpose of the Study:

  • To detail the diagnostic process for autonomic heart dysfunction.
  • To outline appropriate investigations and their interpretation.
  • To emphasize the role of clinical history in diagnosis.

Main Methods:

  • Focus on detailed clinical history taking from patients and witnesses.
  • Review of diagnostic tests including tilt-testing, carotid sinus massage, active stand, cardiovascular autonomic function tests, ambulatory blood pressure monitoring, and ECG loop recorders.
  • Guidance on test performance for maximum diagnostic yield and result interpretation.

Main Results:

  • Clinical history is the primary diagnostic tool for autonomic dysfunction.
  • Specific tests are indicated based on clinical suspicion.
  • Proper execution and interpretation of tests are essential for accurate diagnosis.

Conclusions:

  • Thorough clinical history is paramount in assessing heart autonomic dysfunction.
  • A stepwise approach using appropriate diagnostic tests aids in management.
  • This paper provides a comprehensive guide to the investigation of autonomic cardiovascular control.

Keywords:
Active StandAmbulatory blood pressureCardiovascular Autonomic dysfunctionCarotid Sinus massageInsertable ECG loop recorderSyncopeTilt-testing

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