Patient History: A 35-year-old woman diagnosed as having chronic fatigue syndrome 1 year previously presents with spells of light-headedness and palpitations during the day. Symptoms are most notable with changing from a seated or supine position to standing. She has no other symptoms but recalls that she had an upper respiratory tract infection a few weeks previously, which she treated with over-the-counter agents. Physical Examination: She has an office-based blood pressure of 124/85 mm Hg (lying), 120/80 mm Hg (sitting), and 114/78 mm Hg (standing) and an office-based heart rate of 90 beats/min (lying), 102 beats/min (sitting), and 120 beats/min (standing).
Her urine sodium excretion rate is 140 mmol/24 h. Additional studies excluded the neuropathic variant. However, the patient continues to have symptoms despite initial recommendations. What is the diagnosis and treatment of this…
