65 yr old gentleman came for health check up. Well controlled hypertensive. Amlodep 5 mg morning. C/o dizziness on sudden movements. ECG T wave inversion in lateral leads with LAD. BP supine 160/90 On standing for 3 minutes 140/99 No h/o joint prob tremor anemia tinnitus Rhomberg WNL No DM.
Sent for 2D echo due to ECG change. Grade I/IV dystolic dysfunction Is this orthostatic hypotension? Is increased fluid intake/salt intake advised? Is there a role of midodrine/physostigmine/fludrocortisone in such patients? How safe is it?
