Description
Springer Orthostatic Disorders of the Circulation Mechanisms Manifestations and Treatment 1st Editon 2012 Softbound by David H.P. Streeten
Most of us spend at least two-thirds of our lives either sitting or standing. It is somewhat surprising, therefore, to find not a single book devoted to disorders caused by derangements of the normal physiological adjustments to changes in posture. In fact, until very recently, medical students have not even been advised to measure the blood pressure and heart rate in the upright posture as part of the routine physical examination. Although Bradbury and Eggleston first described orthostatic hypotension as a consequence of autonomic insufficiency in 1925, interest in orthostatic disorders has been slow to develop in the subsequent years. It is well known that the change from recumbency to the standing posture stimulates neurological, endocrine, and cardiovascular adjustments that ensure maintenance of a normal circulation despite the effects of gravitational forces. The mechanisms of these physiological responses to orthostasis have been stud ied by many investigators. Some of the defects to which antigravitational com pensatory mechanisms are subject, such as postural hypotension resulting from autonomic failure, have been studied intensively and have become part of the general knowledge of most medical practitioners. Other orthostatic disorders such as various other postural abnormalities of blood pressure control, and orthostatic edema-have received far less attention and have been unable to compete with the more dramatic and life-threatening ailments of humankind for a place in our standard medical texts. These disorders often give rise to distressing symptoms and may lead to severe impairment of health. 1 Physiology of the Microcirculation.- 1.1. Control of the Peripheral Vasculature.- 1.2. Physiological Requirements Imposed by Orthostasis.- 1.3. Orthostatic Circulatory Adjustments: Neurohumoral Mechanisms.- 1.4. Disorders of the Peripheral Circulation.- 1.5. Orthostatic Disorders of the Circulation.- 1.6. Summary.- 2 Orthostatic Edema: Definition and Pathogenesis.- 2.1. Definition of Orthostatic Edema.- 2.2. General Mechanisms of Edema Formation.- 2.3. Pathogenesis of Orthostatic Edema.- 2.4. Summary.- 3 Orthostatic Edema: Clinical Features.- 3.1. Gender, Age, and Prevalence.- 3.2. Symptoms and Signs.- 3.3. Factors That Aggravate Orthostatic Edema.- 3.4. Laboratory Findings.- 3.5. Summary.- 4 Orthostatic Edema: Diagnosis.- 4.1. Exclusion of Known Types of Edema.- 4.2. Positive Diagnosis of Orthostatic Edema.- 4.3. Summary.- 5 Orthostatic Edema: Treatment and Prognosis.- 5.1. General Aspects.- 5.2. Control of Posture.- 5.3. Dietary and Fluid Restrictions.- 5.4. Conventional Diuretics.- 5.5. Treatment of Potassium Depletion.- 5.6. Elastic Garments and Stockings.- 5.7. Dopamine Agonists.- 5.8. Converting Enzyme Inhibitors: Captopril.- 5.9. Vasoconstrictors.- 5.10. Summary of Therapeutic Program.- 5.11. Summary.- 6 Orthostatic Disorders of Blood Pressure Control: Definitions and Classification.- 6.1. Technique of Blood Pressure Measurement in the Upright Posture.- 6.2. Orthostatic Blood Pressure and Heart Rate Changes: Normal Limits.- 6.3. Definable Disorders of Blood Pressure and Heart Rate Control.- 6.4. Classification of Orthostatic Disorders of Blood Pressure Control.- 6.5. Summary.- 7 Orthostatic Disorders of Blood Pressure Control: Pathocenesis.- 7.1. Orthostatic Hypotension.- 7.2. Orthostatic Hypertension and Other Types of Orthostatic Blood Pressure Disorders.- 7.3. Causes of Orthostatic Blood Pressure Disorders.- 7.4. Pathogenesis of Orthostatic Blood Pressure Disorders Associated with Intact Autonomic Function.- 7.5. Conclusions.- 7.6. Summary.- 8 Orthostatic Disorders of Blood Pressure Control: Clinical Features.- 8.1. Frequency of Main Symptoms.- 8.2. Intracranial Features.- 8.3. Other Clinical Features.- 8.4. Summary.- 9 Orthostatic Disorders of Blood Pressure Control: Prevalence and Diagnosis.- 9.1. Prevalence.- 9.2. Sex Incidence and Age of Onset.- 9.3. Hereditary Factor.- 9.4. Diagnosis of Orthostatic Blood Pressure Derangements.- 9.5. Summary.- 10 Orthostatic Disorders of Blood Pressure Control: Treatment and Prognosis.- 10.1. Treatment.- 10.2. Prognosis.- 10.3. Summary.- Appendix I Clinical and Laboratory Data Obtained in 169 Patients with Orthostatic and Nonorthostatic Edema.- Appendix II Clinical and Laboratory Data Obtained in 159 Patients with Orthostatic Blood Pressure Disorders.- References.