McCarty Niamh, Silverman Barry
Division of Cardiovascular Medicine, Northside Hospital, Atlanta, Georgia.
Proc (Bayl Univ Med Cent). 2016 Apr;29(2):157-9. doi: 10.1080/08998280.2016.11929397.
Cardiovascular autonomic neuropathy often goes unrecognized. We present a case of a 22-year-old man with multiple manifestations of this disease, including weakness, dizziness, fatigue, tachycardia, abnormal QTc, and orthostasis, which occurred 2 years after his type 1 diabetes diagnosis. He exhibited parasympathetic denervation with resting tachycardia and exercise intolerance but also had evidence of orthostatic hypotension, which suggests sympathetic denervation. He did not have complete cardiovascular autonomic reflex testing, which would have been helpful, but improved with aggressive diabetes treatment and the increase of beta-blockade. It is important to identify these patients to understand their signs and symptoms and consider appropriate therapies.
心血管自主神经病变常常未被识别。我们报告一例22岁男性患者，患有该疾病的多种表现，包括虚弱、头晕、疲劳、心动过速、QTc异常和直立性低血压，这些症状在他被诊断为1型糖尿病两年后出现。他表现出副交感神经去神经支配，伴有静息性心动过速和运动不耐受，但也有直立性低血压的证据，提示交感神经去神经支配。他未进行完整的心血管自主神经反射测试（这会有所帮助），但通过积极的糖尿病治疗和增加β受体阻滞剂治疗后病情有所改善。识别这些患者以了解他们的体征和症状并考虑适当的治疗方法很重要。
