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Autonomic Failure Diagnosis

Discussion in 'Other specific illnesses' started by Mij, Aug 10, 2022.

  1. Mij

    Mij Senior Member (Voting Rights)

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    For over 30 years, Finapres® devices have been used by cardiologists, neurologists, physiologists and researchers to better understand autonomic failure, or dysautonomia.

    Many studies using Finapres devices® have been performed to show subjects’ neurological and cardiovascular reactions, including autonomic failure. Finapres® NOVA hardware and software support protocol-driven diagnosis of autonomic failure in patients and support documentation of treatment progress.

    https://www.finapres.com/application-field/autonomic-failure-diagnosis/
     
    DokaGirl and Peter Trewhitt like this.
  2. cassava7

    cassava7 Senior Member (Voting Rights)

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    I’m not sure there is any need for proprietary devices in the diagnosis of orthostatic hypotension or postural orthostatic tachycardia. The only material required is a blood pressure and heart rate monitor, which is standard in all GP practices and hospitals — one can do without a tilt table as a 10 minute active standing test is as much or possibly more specific.

    If anything, doctors may be drawn away from diagnosing these conditions if they are made to believe that expensive equipment is needed.
     
    Hutan, TigerLilea, bobbler and 4 others like this.
  3. Mij

    Mij Senior Member (Voting Rights)

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    Hutan, bobbler, alktipping and 2 others like this.
  4. cassava7

    cassava7 Senior Member (Voting Rights)

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    It may depend on what we are referring to — screening for POTS or orthostatic hypotension, or diagnosing the underlying cause (if applicable). The former is straightforward.

    Concerning the latter, per the Canadian Cardiovascular Society’s POTS guideline, which Dr Raj (in the video you linked to) contributed to, the diagnosis of POTS should be also be straightforward, except in unclear cases, where a differential diagnosis such as a heart condition is suspected or to a lesser extent if it is secondary (e.g. as a side effect of a medication or if it results from a disease such as Parkinson’s or diabetic neuropathy, though in those cases the culprit would likely already be diagnosed).

    Therefore, I struggle to see a need for new devices.


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    Last edited: Aug 10, 2022
  5. chrisb

    chrisb Senior Member (Voting Rights)

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    Have you tried getting a GP to do an "active standing test"? Or even to acknowledge the results of one conducted at home? Or to agree a protocol whereby the results of a home conducted test might be deemed worthy of consideration?
     
    livinglighter, Hutan, bobbler and 2 others like this.
  6. Amw66

    Amw66 Senior Member (Voting Rights)

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  7. bobbler

    bobbler Senior Member (Voting Rights)

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    I haven't read the details of this one but agree that should something be developed that could effectively provide more time for data collection, rather than the 'present the issue on demand', as well as removing the need for offices and trained staff, is a potentially good thing.

    If this were taken seriously you could imagine how something if it were good enough could become something monitored annually by a practice nurse like diabetes or other areas. ie not only could it help those who struggle to get diagnosed but if taken on by e.g. the NHS could actually really push forward treatment if combined with patient feedback and good physicians to use the data to develop guidelines and protocols (which could then inform said reviews on what results mean).

    The hard bit seems to be the push we are seeing (which has surprised me) for trying it on that all of these are somehow in any way mind-body related bla bla. Which I'd guess is what the real issue behind lack of diagnosis rather than equipment of any of the above for many?

    What is the issue with this and why? I get the impression that with these developments in place POTS would be cheaper to treat and such treatment have a massive gain in fewer appts and less debility than any of their #newnameeachyear alternatives so don't even buy the 'money' agenda being behind this one.. EDIT* by which I mean 'claims it saves money' (like IAPT claims for CBT for MUS/LTC)

    Is it just a really boring but slog of a specialty noone wants to work in vs the alternatives? I'm genuinely curious
     
    Last edited: Sep 23, 2022
  8. Hutan

    Hutan Moderator Staff Member

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    Location:
    Aotearoa New Zealand
    That seems to be the guts of the Finapres product - it says it can do 24/7 monitoring I think there might be other products that do the same. I guess the advantages are that it's continuous monitoring and less annoying than having a BP arm cuff that inflates periodically .

    It's certainly better than a one-off test in the doctor's office - it's giving information about what happens when the patient goes about their daily life.
     
    alktipping, bobbler, Amw66 and 2 others like this.

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