Open Access

REVIEW

Pediatric dysautonomia: Much‐maligned, often overmedicated, but not as complex as you think

by

1 Division of Pediatric Cardiology, Department of Pediatrics, University of Alabama School of Medicine, Birmingham, Alabama
2 Division of Pediatric Cardiology, Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia
3 Division of Pediatric Cardiology, Department of Pediatrics, East Carolina University Brody School of Medicine, Greenville, North Carolina

* Corresponding Author: Dr. Camden Hebson, Women and Infants Center, 1700 6th Ave South, Suite 9100, Birmingham, AL 35233. Email:

Congenital Heart Disease 2019, 14(2), 156-161. https://doi.org/10.1111/chd.12720

Abstract

Dysautonomia is an increasingly recognized yet still poorly understood disease within the field of pediatrics. Symptoms, including dizziness, headaches, fatigue, joint pain, anxiety, and intolerance of heat or cold, are often significant and difficult to sort, especially in terms of their relation to each other. This often leads to referral to multiple subspecialists, who then proceed to treat seemingly familiar symptoms in kind. In the authors’ experience, this leads to more frustration on the part of the patients and their physicians when symptom improvement does not follow (or can even worsen). On the other hand, by understanding the pathophysiology, treatment success is possible by directing therapies toward the root causes and just as importantly, enlisting the patient in a daily treatment plan. In the text that follows, we hope to convey these viewpoints by highlighting an involved case, discussing the pathophysiology, outlining the usual evaluation, and finally describing our approach to treatment.

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Keywords

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