Case history
Case history #1
A 20-year-old woman presents with 4 months of fatigue, brain fog, and palpitations and lightheadedness on standing up. Prior to this, the patient was diagnosed with infectious mononucleosis. The patient reports occasional migraine headaches in the past but no other significant medical history. Physical examination shows a supine heart rate of 85 bpm and blood pressure of 105/60 mmHg. After 1 minute of standing, her heart rate is 123 bpm and blood pressure is 97/ 62 mmHg. The rest of the physical examination is unremarkable.
Case history #2
A 13-year-old girl presents with a 5-month history of standing intolerance due to palpitations and severe dizziness. Her symptoms resolve after lying flat. The patient also reports occasional nausea, bloating, and constipation. Her periods started 6 months ago and she also has a history of poor wound healing. On examination she has stretch marks on her skin, hyperextensibility, and joint hypermobility. Her supine vital signs show her heart rate is 89 bpm and blood pressure is 105/59 mmHg. On standing, her heart rate is 132 bpm and her blood pressure is 102/65 mmHg.
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