Orthostatic intolerance: A disorder of young women

Orthostatic intolerance (OI) is a cause of significant disability in otherw ise healthy women seen by gynecologists. Orthostatic tachycardia is often t he most obvious hemodynamic abnormality found in OI patients, but symptoms may include dizziness, visual changes, discomfort in the head or neck, poor concentration, fatigue, palpitations, tremulousness, anxiety, and, in some cases, fainting (syncope). It is the most common disorder of blood pressur e regulation after essential hypertension, and patients with OI are traditi onally women of childbearing age. Estimates suggest that at least 500,000 A mericans suffer from some form of OI, and such patients comprise the larges t group referred to centers specialized in autonomic disorders. This articl e reviews recent advances made in the understanding of this condition, pote ntial pathophysiological mechanisms contributing to orthostatic intolerance , and therapeutic alternatives currently available for the management of th ese patients. Target Audience: Obstetricians & Gynecologists, Family Physicians Learning Objectives: After completion of this article, the reader will be a ble to describe the common signs and symptoms associated with idiopathic or thostatic intolerance, to identify the various conditions that have similar presentations as idiopathic orthostatic intolerance and to describe potent ial treatment options.