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  1. Postural Orthostatic Tachycardia Syndrome: Dysautonomia, Orthostatic Intolerance, Supine Position,Tachycardia, Cerebral Blood Flow, Orthostatic Hypotension

41. Blackwell Synergy - Cookie Absent
postural orthostatic tachycardia syndrome (POTS) has recently emerged as a A diagnosis of postural orthostatic tachycardia syndrome was made based on
http://www.blackwell-synergy.com/doi/abs/10.1111/j.1540-8159.2004.00477.x
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42. EMedicine - Orthostatic Intolerance: An Overview : Article By Julian M Stewart,
Pooling with acrocyanosis and edema in postural tachycardia syndrome (POTS). orthostatic intolerance of the postural orthostatic tachycardia syndrome.
http://www.emedicine.com/ped/topic2860.htm
(advertisement) Home Specialties Resource Centers CME ... Patient Education Articles Images CME Advanced Search Consumer Health Link to this site Back to: eMedicine Specialties Pediatrics Cardiology
Orthostatic Intolerance: An Overview
Last Updated: March 7, 2003 Rate this Article Email to a Colleague Synonyms and related keywords: orthostasis, faint, simple faint, fainting, syncope, postural tachycardia syndrome, POTS, hyperadrenergic orthostatic hypotension, sympathotonic orthostatic tachycardia, idiopathic hypovolemia, neurocardiogenic syncope, neurally mediated syncope, NMH, vasovagal syncope AUTHOR INFORMATION Section 1 of 10 Author Information Introduction And Definition Variants Of Orthostatic Intolerance Physiology Of Orthostasis ... Bibliography
Author: Julian M Stewart, MD, PhD , Director of Center for Pediatric Hypotension, Professor, Departments of Pediatrics and Physiology, Division of Pediatric Cardiology, Westchester Medical Center and New York Medical College Julian M Stewart, MD, PhD, is a member of the following medical societies: American Academy of Pediatrics Editor(s): Juan Carlos Alejos, MD

43. EMedicine - Autonomic Neuropathy : Article Excerpt By: Cory Toth, BSc, MD, FRCPC
postural orthostatic tachycardia syndrome (POTS) is a syndrome most common inyoung females with orthostatic intolerance characterized by palpitations with
http://www.emedicine.com/neuro/byname/autonomic-neuropathy.htm
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Excerpt from Autonomic Neuropathy
Synonyms, Key Words, and Related Terms:
Please click here to view the full topic text: Autonomic Neuropathy
Background: Autonomic neuropathies are a collection of syndromes and diseases affecting the autonomic neurons, either parasympathetic or sympathetic, or both. Autonomic neuropathies can be hereditary or acquired in nature. Most often, they occur in conjunction with a somatic neuropathy, but they can also occur in isolation. The autonomic nervous system modulates numerous body functions, and therefore, dysfunction of this system can manifest with numerous clinical phenotypes and various laboratory and electrophysiologic abnormalities. Often, a patient may present with symptoms related to a single segment of the autonomic system. The physician must be wary of other affected parts of the autonomic system. In some forms, the degree and type of autonomic system involvement varies extensively. In some patients, the degree of autonomic dysfunction may be subclinical or clinically irrelevant, while in others symptoms may be disabling. Several clinically important features of autonomic neuropathies can be treated with either conservative or pharmacologic therapies; therefore, the physician must be alert to these features. Pathophysiology: The pathophysiology of the autonomic neuropathy depends on the etiology of each particular type. These may range from genetic disorders with specific gene defects to metabolic disorders with accumulation of toxins and to autoimmune disorders with identifiable autoantibodies. Although it is accepted that a loss of somatic C fibers is associated with autonomic deficits, selective involvement is now known to occur for specific autonomic neuropathies. For example, diabetic neuropathies are associated with somatic and autonomic C-fiber impairment, while neuropathic postural tachycardia syndrome is associated with selective distal autonomic deficit (Singer, 2004).

44. Journal Of Cardiovascular Pharmacology - UserLogin
postural orthostatic tachycardia syndrome; Betaadrenergic blockade; Cyclic AMP;Head-up tilt test. © 2000 Lippincott Williams Wilkins, Inc.
http://www.cardiovascularpharm.com/pt/re/jcardiopharm/fulltext.00005344-20000000
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45. Journal Of Cardiovascular Pharmacology - Abstract: Volume 36(&NA;) 2000 P S79-S8
Plasma Cyclic AMP Responses to Isoproterenol Infusion and Effect of BetaAdrenergicBlockade in Patients with postural orthostatic tachycardia syndrome.
http://www.cardiovascularpharm.com/pt/re/jcardiopharm/abstract.00005344-20000000
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Permissions Heart Rate and Plasma Cyclic AMP Responses to Isoproterenol Infusion and Effect of Beta-Adrenergic Blockade in Patients with Postural Orthostatic Tachycardia Syndrome.
Journal of Cardiovascular Pharmacology. 36 Supplement 2 to issue 6:S79-S82, 2000.
Abe, Haruhiko; Nagatomo, Toshihisa; Kohshi, Kiyotaka *; Numata, Tetsuya; Kikuchi, Kan +; Sonoda, Shinjo +; Mizuki, Tsunetaka +; Kuroiwa, Akio +; Nakashima, Yasuhide Abstract:
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46. Chat - Fall 1997
Orthostatic Intolerance Syndromes. Postural Tachycardia Syndrome (POTS), Orthostatic Tachycardia Syndrome. postural orthostatic tachycardia syndrome
http://www.ndrf.org/NDRFChat.htm
NDRF
National Dysautonomia Research Foundation
PO Box 301, Red Wing, MN 55066-0301
Phone: (651) 267-0525 Fax: (651) 267-0524

Be sure to visit the NDRF Reference Page where you can learn more about the NDRF Patient Handbook, Videos and other reference materials.
NDRF Chat Fall 1997
Table of Contents:
Orthostatic Intolerance Syndromes: Dr. David Robertson, Vanderbilt University, Nashville, TN FAQ's : Dr. Phillip Low, Mayo Clinic, Rochester Health Tips: Dr. Kathryn Boehm NDRF Updates: Linda J. Smith 1407 W 4th St, Suite 160, Red Wing, MN 55066 NDRF Chat Orthostatic Intolerance Syndromes: Postural Tachycardia Syndrome (POTS), Mitral Valve Prolapse Dysautonomia (MVP), Idiopathic Hypovolemia Since our start in April of this year, NDRF has received calls, letters and e-mail daily. Due to the large number of calls we receive from those who suffer from Orthostatic Intolerance Conditions, NDRF felt that our first newsletter should focus on this area. We have asked some of the leading physicians who treat these disorders to help us by providing a summary of the conditions, answering some frequently asked questions, and giving some helpful health tips to assist in managing Orthostatic Intolerance. We hope that this newsletter will provide you with information that will help you better understand and manage your condition. Our website also may provide you with some information - be sure to visit us and drop us a note.

47. Chat - Summer 99
postural orthostatic tachycardia syndrome (POTS). Mitral Valve Prolapse Syndrome Idiopathic Orthostatic Intolerance and Postural Tachycardia Syndromes
http://www.ndrf.org/ChatSummer99.htm
NDRF
National Dysautonomia Research Foundation
PO Box 301, Red Wing, MN 55066-0301
Phone: (651) 267-0525 Fax: (651) 267-0524

Be sure to visit the NDRF Reference Page where you can learn more about the NDRF Patient Handbook, Videos and other reference materials.
S ummer 1999Newsletter
NDRF Chat
Table of Contents
Orthostatic Intolerance Update
Update: NASA's Neurolab
Web Updates:
HHS Panel on Interactive Health Services
NLM's Medline Search Engine
Inside
Updates:
NDRF 2000 Conference
NDRF Education Outreach Program
Support Group Coordinators
NDRF Relocation/Phone numbers
Contributions
Introduction The terminology used in describing autonomic disorders can often be confusing. When reading information on Orthostatic Intolerance conditions (OI), it is easy to become bewildered by the various conditions that all appear to have the same set of symptoms. NDRF receives numerous calls from individuals seeking help in determining the differences between: Postural Orthostatic Tachycardia Syndrome (POTS) Mitral Valve Prolapse Syndrome Chronic Orthostatic Intolerance (COI) Idiopathic Hypovolemia Idiopathic Orthostatic Intolerance Research efforts into the underlying mechanisms and treatment programs for OI continue to move at a rapid rate. The recent publication of The American Journal of the Medical Sciences supplement on Orthostatic Intolerance and Orthostatic Tachycardia (February, 1999) has provided a valuable reference source that helps to explain current understandings, history and treatment plans for these conditions.

48. Orthostatic Intolerance In Adolescent Chronic Fatigue Syndrome -- Stewart Et Al.
Reflex vascular defects in the orthostatic tachycardia syndrome of adolescents orthostatic intolerance of the postural orthostatic tachycardia syndrome
http://pediatrics.aappublications.org/cgi/content/abstract/103/1/116
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This Article Full Text Full Text (PDF) P ... Citation Map Services E-mail this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal ... Cited by other online articles PubMed PubMed Citation Articles by Stewart, J. M. Articles by Munoz, J. Related Collections Office Practice PEDIATRICS Vol. 103 No. 1 January 1999, pp. 116-121
Orthostatic Intolerance in Adolescent Chronic Fatigue Syndrome
Received Apr 29, 1998; accepted Jul 17, 1998. Julian M. Stewart Michael H. Gewitz Amy Weldon Nina Arlievsky Karl Li and Jose Munoz From the Department of Pediatrics, Divisions of Cardiology, and Immunology and Infectious Disease, New York Medical College, Valhalla, New York. Objectives. To demonstrate the association between orthostatic intolerance and the chronic fatigue syndrome (CFS) in adolescents and to delineate the form that orthostatic intolerance takes in these children.

49. Journal Of Hypertension - Fulltext: Volume 22(4) April 2004 P 671-673 Low Blood
Review the postural orthostatic tachycardia syndrome current concepts inpathophysiology, diagnosis and management. J Intervent Cardiac Electrophysiol
http://www.jhypertension.com/pt/re/jhypertension/fulltext.00004872-200404000-000
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References (19) Permissions View full size inline images Journal of Hypertension Volume 22(4) April 2004 pp 671-673
Low blood pressure and low energy: (how) are they related?
Tonkin, Anne Department of Clinical and Experimental Pharmacology, University of Adelaide and Royal Adelaide Hospital, Adelaide, South Australia, Australia. Correspondence and requests for reprints to Anne Tonkin, Department of Clinical and Experimental Pharmacology, University of Adelaide and Royal Adelaide Hospital, Adelaide, South Australia, Australia. E-mail: anne.tonkin@adelaide.edu.au See original paper on page 691 An association between low blood pressure and fatigue, in various forms, has been postulated for several decades but has remained unproven. In this issue of the journal, Lucas et al ] have demonstrated a prospective association between hypotension and unexplained chronic fatigue as an isolated symptom. et al ], 'easy fatiguability', differ markedly from those of a diagnosis of 'chronic fatigue syndrome' (CFS) based on standard diagnostic criteria. ] and 22% [ ] of general practice samples, respectively, and is frequently treated with drugs such as fludrocortisone or sympathomimetics, which increase blood pressure. In other regions, such as the UK, North America and Australasia, people with chronically low blood pressure readings are generally regarded as belonging to the normal population, albeit at the extreme end of the distribution curve. Such individuals are assumed to autoregulate their cerebral perfusion around a low mean blood pressure and their 'hypotension' is therefore regarded as being unlikely to cause symptoms related to cerebral hypoperfusion. Standard medical textbooks in these regions do not include entries for the diagnosis or management of constitutional hypotension.

50. Current Opinion In Cardiology - UserLogin
postural orthostatic tachycardia syndrome TOP. Postural orthostatic tachycardiasyndrome probably represents a heterogeneous group of conditions.
http://www.co-cardiology.com/pt/re/cocardio/fulltext.00001573-200103000-00003.ht
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51. Coi
postural orthostatic tachycardia syndrome gives an excellent overview of dysautonomiaand is particularly strong in explaining cervical stenosis and Chiari
http://home.bluecrab.org/~health/coi/coi.html
Chronic Orthostatic Intolerance (COI) Also called:
  • D ysautonomia Neurally Mediated Hypotension (NMH) Neurally Mediated Syncope Orthostatic syncope Postural Tachycardia Syndrome (POTS)

In all of these conditions, upright posture makes the person sick. Walking and running are actually easier than standing or sitting still. The symptoms caused by standing or sitting may include any of the following: fainting, dizziness, nausea, feeling very tired, feeling excessively jittery, having difficulty concentrating or remembering things, experiencing pain in the lower parts of the abdomen or in the legs, mottling or purpling of hands, ankles, feet and legs, hot flushes, sweating, and headache. The underlying cause is a disruption of the autonomic nervous system. This system automatically regulates bodily functions, including heart rate and blood pressure. It also responds to postural or orthostatic stress. Blood is a liquid. It tries to flow downward. When you are standing it tends to run into your legs and feet. This deprives your upper body and, especially, your brain, of an adequate blood supply. The autonomic nervous system prevents this by regulating how the heart beats and by constricting blood vessels in the lower parts of the body, forcing blood upward. In people with COI, this system doesn't work right and blood tends to pool in the belly, legs, and feet. It will pool in the hands, too, if the arms are dangling. This is what causes the mottling or purpling of the skin usually seen in COI..

52. Entrez PubMed
The postural orthostatic tachycardia syndrome a potentially treatable cause ofchronic fatigue, exercise intolerance, and cognitive impairment in
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=1

53. Autonomic Nervous System Dysfunction In Adolescents With Postural Orthostatic Ta
POTS, postural orthostatic tachycardia syndrome HUT, headup tilt CDC, Centersfor Disease Control and Prevention BP, blood pressure LF, low frequency
http://www.pedresearch.org/cgi/content/full/48/2/218
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International Pediatric Research Foundation, Inc.
Autonomic Nervous System Dysfunction in Adolescents with Postural Orthostatic Tachycardia Syndrome and Chronic Fatigue Syndrome Is Characterized by Attenuated Vagal Baroreflex and Potentiated Sympathetic Vasomotion
JULIAN M. STEWART Department of Pediatrics, The Center for Pediatric Hypotension, New York Medical College, Valhalla, New York 10595, U.S.A. Correspondence: Julian M. Stewart, M.D., Ph.D., The Center for Pediatric Hypotension and Division of Pediatric Cardiology, Suite 618, Munger Pavilion, New York Medical College, Valhalla, NY 10595, U.S.A.
ABSTRACT TOP
ABSTRACT
INTRODUCTION
METHODS
RESULTS
DISCUSSION REFERENCES The objective was to determine the nature of autonomic and vasomotor changes in adolescent patients with orthostatic tachycardia associated with the chronic fatigue syndrome (CFS) and the postural orthostatic tachycardia syndrome (POTS). Continuous electrocardiography

54. Inappropriate Early Hypotension In Adolescents: A Form Of Chronic Orthostatic In
postural orthostatic tachycardia syndrome patients were divided into two groupsby the occurrence of INOH. Supine forearm and calf arterial resistance was
http://www.pedresearch.org/cgi/content/abstract/50/1/97
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This Article Full Text Full Text (PDF) correspondence: Submit a response ... Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager PubMed PubMed Citation Articles by STEWART, J. M. Articles by WELDON, A. Pediatric Research
International Pediatric Research Foundation, Inc.
Inappropriate Early Hypotension in Adolescents: A Form of Chronic Orthostatic Intolerance with Defective Dependent Vasoconstriction
JULIAN M. STEWART and AMY WELDON Departments of Pediatrics [J.M.S., A.W.] and Physiology [J.M.S.], The Center for Pediatric Hypotension, New York Medical College Valhalla, NY 10595, U.S.A. Correspondence and reprint requests: Julian M. Stewart, M.D., Ph.D., Department of Pediatrics, The Center for Pediatric Hypotension and The Division of Pediatric Cardiology, Suite 618, Munger Pavilion, New York Medical College, Valhalla, NY 10595, U.S.A.; e-mail: ABSTRACT Instantaneous orthostatic hypotension (INOH) has been reported in children and adolescents as a new entity of orthostatic intolerance in children who underwent rapid standing as an orthostatic stress test. Children with INOH were discovered among patients

55. NMH - Our FM/CFS World
Site on postural orthostatic tachycardia syndrome (POTS). National DysautonomiaResearch Foundation. Neurally Mediated Hypotension
http://www.ourfm-cfidsworld.org/html/nmh.html
Our FM/CFS World, Inc. Subscribe to our FREE newsletter Search
our site
Neurally Mediated Hypotension Our FM/CFS World, Inc.
would like to give a special thank you to Robyn Pollman. Robyn dedicated her time and effort to maintain an impressive NMH web site. She graciously offered to give us her information for inclusion on our site, so that people can continue to be helped through her work. We are truly grateful that she has entrusted us with this gift. What you need to know about Neurally Mediated
Hypotension and Chronic Fatigue Syndrome
You may have heard about a new research project at Johns Hopkins University School of Medicine that ties Chronic Fatigue Syndrome (CFS or CFIDS) and a problem with blood pressure regulation. Here is our current understanding: Q: What is neurally mediated hypotension A: Neurally mediated hypotension (NMH) is a condition in which the body has difficulty regulating the blood pressure, especially when one is upright. There seems to be a misconnection between the brain and the nerves that control the blood pressure and heart rate. The reason is unknown. Q: What happens in this condition A: People with this condition experience spells in which the blood pressure drops suddenly, leading to weakness, lightheadedness or dizziness, sweating, vision disturbance and a feeling of fainting or near-fainting. During an episode, some people may get an irresisible urge to sit or lie down or a feeling that something bad may happen if they remain standing.

56. The American Journal Of The Medical Sciences - Abstract: Volume 317(2) February
Patients with the postural orthostatic tachycardia syndrome (POTS) have symptomsof orthostatic intolerance despite having a normal orthostatic blood
http://www.amjmedsci.com/pt/re/ajms/abstract.00000441-199902000-00007.htm
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Cerebrovascular Regulation in the Postural Orthostatic Tachycardia Syndrome (POTS).
American Journal of the Medical Sciences. Orthostatic Intolerance and Orthostatic Tachycardia. 317(2):124-133, February 1999.
LOW, PHILLIP A. MD *; NOVAK, VERA MD, PhD +; SPIES, JUDITH M. MD *; NOVAK, PETER MD +; PETTY, GEORGE W. MD * Abstract:
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57. Fainting
postural orthostatic tachycardia syndrome Postural Orthostatic TachycardiaSyndrome (POTS) is clinically defined as a heart rate increase of 30 bpm or more
http://www.geocities.com/HotSprings/Falls/8173/fainting.html
Causes of Dizziness
Common causes of dizziness are Neurally Mediated Hypotension (NMH), Orthostatic Hypotension (OH), inner ear infections and anxiety. Both NMH and OH causes a drop in blood pressure but under different circumstances.
There are differences in the description of the terms to describe dizziness.
Faint: feeling weak or as if ready to pass out (may or may not actually pass out) from drop in blood volume in the brain.
Virtigo: sensation of room spinning from possibly disequalibrium or being off balance.
Links to Sites for More Information on Causes of Dizziness
The Vestibular Disorders Association
Symptoms of vestibular disorders (inner ear problems) may include dizziness, imbalance, vertigo, nausea, and fuzzy vision, and may be accompanied by hearing problems. Other symptoms are often reported.
Neurosciences on the Internet
Dizziness and Tinnitus links.
NEURO-OTOLOGY (VERTIGO, DIZZINESS AND HEARING DISORDERS)
Site by B. Todd Troost, M.D. gives detailed information on Vertigo, Dizziness and Hearing Disorders.
Postural Orthostatic Tachycardia Syndrome
Postural Orthostatic Tachycardia Syndrome (POTS) is clinically defined as a heart rate increase of 30 bpm or more from the supine (laying down) to the standing position within ten minutes or less. Site provides a lot of information and links.

58. Nature Clinical Practice Cardiovascular Medicine | The Sinus Tachycardias
postural orthostatic tachycardia syndrome (POTS) is an abnormal sinus tachycardiatriggered by orthostasis and relieved by recumbency.4 Significant
http://www.nature.com/ncpcardio/journal/v2/n1/full/ncpcardio0068.html
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The sinus tachycardias
Shamil Yusuf* and A John Camm Correspondence * Department of Cardiovascular Medicine, St George's Hospital Medical School, Cranmer Terrace, London SW17 0RE, UK
Email syusuf@sghms.ac.uk Sinus tachycardia is frequently encountered in clinical practice but is often overlooked. It comprises four distinct rhythm disturbances namely normal sinus tachycardia, inappropriate sinus tachycardia, postural orthostatic tachycardia syndrome and sinus node re-entry tachycardia. The important differences in clinical features, basic underlying etiologic mechanisms and treatment strategies of these arrhythmias are discussed here. Full text of this article is available with one of the following:
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  • 59. Vascular Perturbations In The Chronic Orthostatic Intolerance Of The Postural Or
    Idiopathic postural orthostatic tachycardia syndrome an attenuated form of acutepandysautonomia? Neurology 43 132137, 1993Abstract.
    http://jap.physiology.org/cgi/content/full/89/4/1505
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    PubMed PubMed Citation Articles by Stewart, J. M. Articles by Weldon, A. Vol. 89, Issue 4, 1505-1512, October 2000
    Vascular perturbations in the chronic orthostatic intolerance of the postural orthostatic tachycardia syndrome
    Julian M. Stewart and Amy Weldon Departments of Pediatrics and Physiology, Center for Pediatric Hypotension, New York Medical College, Valhalla, New York 10595
    ABSTRACT TOP
    ABSTRACT
    INTRODUCTION
    METHODS
    RESULTS DISCUSSION REFERENCES Chronic orthostatic intolerance is often related to the postural orthostatic tachycardia syndrome (POTS). POTS is characterized by upright tachycardia. Understanding of its pathophysiology remains

    60. Cerebral And Systemic Hemodynamics Changes During Upright Tilt In Chronic Fatigu
    The roles of orthostatic hypotension, orthostatic tachycardia, Grubb BP,Kosinski DJ, Boehm K, Kip K. postural orthostatic tachycardia syndrome a
    http://jon.sagepub.com/cgi/content/refs/13/1/57

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    Journal of Neuroimaging, Vol. 13, No. 1, 57-67 (2003)
    DOI: 10.1177/1051228402239719
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    Cerebral and Systemic Hemodynamics Changes During Upright Tilt in Chronic Fatigue Syndrome
    Alexander Y. Razumovsky, PhD Karen DeBusk, Hugh Calkins, MD Sally Snader, Katherine E. Lucas, MHS Pranav Vyas, MD Daniel F. Hanley, MD Peter C. Rowe, MD Background and Purpose . During head-up tilt (HUT), patients with chronic fatigue syndrome (CFS) have higher rates of neurally mediated hypotension (NMH) and postural tachycardia syndrome (POTS) than healthy controls. The authors studied whether patients with CFS were also more likely to have abnormal cerebral blood flow velocity (CBFV) compared with controls in response to orthostatic stress.

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