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Mystery Case Solved: A patient with orthostatic hypotension refractory to standard medical treatment

Tai Thien Tan Tri Truyen, Hy Tat An, Gianluca Rigatelli, Thach Nguyen


Three months ago, an elderly male patient came to the hospital with orthostatic hypotension. His supine blood pressure (BP) was 160/8mmHg and his standing BP was 80/45mmHg. The patient was started on midodrine 10mg TID and fludrocortisoneacetate. He felt less dizzy even the BP still decreased to 110/80 on standing. He was sent home because he became asymptomatic with mild to moderate orthostatic hypotension. However, today he came back to the emergency room with syncope.

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