![]() The pathophysiology of orthostatic hypotension is that people, when standing, have pooling of blood in both the lower extremities and splanchnic circulation. ![]() ![]() 1 A person is said to be “orthostatic positive” if one of the following is true: a reduction of systolic blood pressure of at least 20mmHg a reduction in diastolic blood pressure of at least 10mmHg or an increase in heart rate by >30 beats per minute, when comparing lying to standing. When performed correctly, orthostatic vital signs measure blood pressure and pulse changes in a sequence of lying, sitting, and standing, waiting 3 minutes between each position. Are orthostatic vital signs useful in the workup of this patient? She has a history of depression and hypercholesterolemia, but otherwise an unremarkable history. The patient was working outside, serving hotdogs at a concession stand during the summer. Her vitals upon arrival are: blood pressure 138/84 pulse 74 respirations 16 and oxygen saturation 98% on room air. A 46-year-old female presents to the emergency department with a chief complaint of syncope, continuing to feel unwell and lightheaded.
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