[Orthostatic Intolerance: A Clinical Approach].

Area of Science:

• Cardiology
• Neurology
• Internal Medicine

Background:

• Syncope and dizziness are common reasons for emergency department visits.
• A thorough medical history and physical examination are crucial for diagnosis.
• Certain red flags, such as new ECG changes or syncope during exertion, warrant further investigation.

Purpose of the Study:

• To present a clinical approach to diagnosing and managing orthostatic intolerance.
• To highlight the importance of autonomic testing in evaluating dizziness and syncope.
• To guide clinicians on when further autonomic testing may be indicated.

Main Methods:

• Review of clinical approaches to orthostatic intolerance.
• Emphasis on careful patient history and physical examination.
• Discussion of autonomic testing, including tilt table testing.

Main Results:

• Orthostatic intolerance is a primary cause of dizziness and syncope.
• Autonomic testing, when interpreted alongside clinical data, aids diagnosis.
• A structured clinical approach can effectively manage these conditions.

Conclusions:

• A systematic clinical evaluation is essential for patients presenting with syncope or dizziness.
• Orthostatic intolerance should be considered, and autonomic function testing may be required.
• Judicious use of diagnostic tools, including tilt table testing, improves patient outcomes.