Bruce H. Knox
Independent Scholar, Auckland, New Zealand
Publications
-
Case Study
Multifactorial Secondary Autonomic Dysfunction Integrating Classical Orthostatic Hypotension, Delayed Orthostatic Deterioration, Exercise-Induced Hypotension, Supine Hypertension, and Chronotropic Limitation
Author(s): Bruce H. Knox*
Background: A single patient may show an immediate orthostatic blood-pressure fall, later deterioration during continued walking, and an apparently limited heart-rate response. These observations are related, but they do not automatically establish three separate diagnoses. Case: This clinical narrative concerns a 74-year-old man with long-standing secondary autonomic dysfunction after severe post-infectious illness, later compounded by cardiac disease and major cardiac intervention. Classical orthostatic hypotension and supine hypertension are established features. More recently, sustained upright walking has become associated with a reproducible warning phase after approximately 10–15 minutes, followed by light-headedness, visual disturbance, weakness, loss of gait confidence, and recovery after stopping. Heart-rate acceleration duri.. Read More»