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《orthostatic hypotension》⇒起立性低血圧症
起立性低血圧 ( orthostatic hypotension )
起立性低血圧
(orthostatic hypotension から転送)
出典: フリー百科事典『ウィキペディア（Wikipedia）』 (2023/02/26 02:48 UTC 版)
起立性低血圧（きりつせいていけつあつ、英: orthostatic hypotension）は、安静臥床後起立した際に血圧の低下(起立後3分以内に収縮期血圧で20mmHg以上、拡張期血圧で10mmHg以上の血圧低下 blood pressure fall [1])と代償性脈拍増加が同時に見られ (ただし疾患が進行すると代償性脈拍増加は目立たなくなることが多い、徐脈はみられない) [1] [2] [3]、顔面蒼白となり、意識が遠のく(意識消失・失神)もので、眼前暗黒・頚から肩にかけての痛み(coat-hunger pain)・耳鳴・外傷・ミオクローヌス様の軽い痙攣を伴う場合がある。意識消失中の脳波は徐波化～平坦化している。(血圧低下時に徐脈がみられる神経調節失神と異なる。) 原因は末梢神経疾患・脊髄疾患が多い。原因治療と並行して対症療法を十分に行う。
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- ^ Amy C Arnold, Jessica Ng, Lucy Lei, Satish R Raj (2017). “Autonomic Dysfunction in Cardiology: Pathophysiology, Investigation, and Management”. Can J Cardiol 33: 1524-1534. doi:10.1016/j.cjca.2017.09.008.
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- ^ a b c d 河野律子、荻ノ沢泰司、渡部太一 ほか、起立性低血圧 昭和医学会雑誌 Vol.71 (2011) No.6 p.523-529, doi:10.14930/jsma.71.523
- ^ Guyton, AC; Hall, JE (1996), “Overview of the Circulation; medical physics of pressure, flow, and resistance”, Textbook of medical physiology 9th ed., Philadelphia: W.B. Saunders Company, pp. 161-169, ISBN 0721659446
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- ^ Jones RT. (2002). “Cardiovascular system effects of marijuana.”. J Clin Pharmacol 42 (11 Suppl): 58S–63S. PMID 12412837.
- ^ メルクマニュアル家庭版の起立性低血圧の項
- ^ Cornelia Skowronek, Leonora Zange, Axel Lipp. (2019). “Cardiac 123I-MIBG Scintigraphy in Neurodegenerative Parkinson Syndromes: Performance and Pitfalls in Clinical Practice.”. Front Neurol.: 26;10:152. doi: 10.3389/fneur.2019.00152. eCollection 2019..
- ^ K Yano, T Kuriya, K Hashiba. (1987). “Simultaneous monitoring of electrocardiogram and arterial blood pressure during exercise-induced syncope in a patient with severe aortic stenosis--a case report.”. Angiology.: 40(2):143-8..
- ^ S L Mader, M Wong. (1989). “Orthostatic hypotension due to hypertrophic cardiomyopathy and autonomic failure.”. Am J Med.: 82(6):1243-6..
- ^ Mathias CJ, Bannister RB, Cortelli P, Heslop K, Polak JM, Raimbach S, Springall DR, Watson L. (1990). “Clinical, autonomic and therapeutic observations in two siblings with postural hypotension and sympathetic failure due to an inability to synthesize noradrenaline from dopamine because of a deficiency of dopamine beta hydroxylase.”. Q J Med.: 75(278):617-33..
- ^ Singer W, Opfer-Gehrking TL, McPhee BR, Hilz MJ, Bharucha AE, Low PA. (2003). “Acetylcholinesterase inhibition: a novel approach in the treatment of neurogenic orthostatic hypotension.”. J Neurol Nosurg Psychiatry 74 (9): 1294–8. doi:10.1136/jnnp.74.9.1294. PMID 12933939.
[続きの解説]
「起立性低血圧」の続きの解説一覧
- 1 起立性低血圧とは
- 2 起立性低血圧の概要
- 3 診断と鑑別診断
- 4 治療と対処
- 5 予後
- orthostatic hypotensionのページへのリンク
