Abstract
The clinical ramifications of the differences between P&S monitoring and HRV alone are explored as the differences pertain to the Autonomic Assessment itself. Through this, the format, justification, and contraindication of the clinical autonomic assessment are discussed. The six phases of the clinical autonomic assessment are based on the Ewing challenges, including rest, deep breathing, Valsalva, head-up postural change (standing), and the intervening baselines. The resting phase (initial baseline) enables the patient to be their own control allowing for results on the first assessment. The assessment fulfills the American Diabetes Association’s recommended tests to assess autonomic function, including blood pressure and EKG responses to the Ewing challenges. The unique to P&S monitoring finding of parasympathetic excess (PE) in response to Valsalva or stand is introduced with its clinical implications.
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Colombo, J., Arora, R., DePace, N.L., Vinik, A.I. (2015). Autonomic (Parasympathetic and Sympathetic) Assessment. In: Clinical Autonomic Dysfunction. Springer, Cham. https://doi.org/10.1007/978-3-319-07371-2_5
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DOI: https://doi.org/10.1007/978-3-319-07371-2_5
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