| Abnormal Test . | How to Perform or Order . | References . |
|---|---|---|
| Abnormal NASA Lean Test | After measuring baseline blood pressure and heart rate supine, the patient stands with heels about 6–8 inches from a wall and relaxes and leans against the wall. Record blood pressure, heart rate, and symptoms every minute for 10 minutes (abnormal if heart rate increases >30 beats per minute or rate increases to >120, a decrease in systolic blood pressure of >20, or a decrease in diastolic blood pressure of >10). | [102] |
| Abnormal Sudomotor Assessment | Diagnostic machines are used to perform the QSART or sweat test using electrodes that assess the integrity of small unmyelinated postganglionic sympathetic sudomotor C-fibers. This test may require referral to a practice that provides this testing. | [102] |
| Exaggerated orthostatic blood pressure response on heads-up tilt test | This test is performed at centers with a special table that tilts patients from 0°–30°–45°–70° and records heart rate, blood pressure, and symptoms. Tests are interpreted and results provided for the ordering clinician. | [104] |
| Heart rate variability on 24-hour Holter-ECG monitoring | Obtaining Holter monitoring may require referral to a cardiologist, but in some areas testing can be ordered by primary care providers with provided interpretations. | [105] |
| Abnormal heart rate recovery at 1 minute postexertion | Measuring heart rate at 1 minute postexertion measures the fast phase of recovery; normal is a drop of >18 beats per minute by the first minute postexertion. | [107] |
| Abnormal cardiopulmonary exercise testing results | Cardiopulmonary exercise testing may require a referral to a center or office that uses specialized equipment such as a treadmill or bicycle and ECG monitoring, oximetry monitoring, or a mask with flow monitoring. | [108] |
| Dysrhythmias detected on ECG monitoring | Short in office rhythm strips and Holter monitoring can detect dysrhythmia. | [109, 110] |
| Abnormal pulmonary function testing with inclusion of DLCO testing | While chest radiographs and basic pulmonary function testing can be normal, more abnormalities can be detected with inclusion of DLCO testing. | [111] |
| Abnormal Test . | How to Perform or Order . | References . |
|---|---|---|
| Abnormal NASA Lean Test | After measuring baseline blood pressure and heart rate supine, the patient stands with heels about 6–8 inches from a wall and relaxes and leans against the wall. Record blood pressure, heart rate, and symptoms every minute for 10 minutes (abnormal if heart rate increases >30 beats per minute or rate increases to >120, a decrease in systolic blood pressure of >20, or a decrease in diastolic blood pressure of >10). | [102] |
| Abnormal Sudomotor Assessment | Diagnostic machines are used to perform the QSART or sweat test using electrodes that assess the integrity of small unmyelinated postganglionic sympathetic sudomotor C-fibers. This test may require referral to a practice that provides this testing. | [102] |
| Exaggerated orthostatic blood pressure response on heads-up tilt test | This test is performed at centers with a special table that tilts patients from 0°–30°–45°–70° and records heart rate, blood pressure, and symptoms. Tests are interpreted and results provided for the ordering clinician. | [104] |
| Heart rate variability on 24-hour Holter-ECG monitoring | Obtaining Holter monitoring may require referral to a cardiologist, but in some areas testing can be ordered by primary care providers with provided interpretations. | [105] |
| Abnormal heart rate recovery at 1 minute postexertion | Measuring heart rate at 1 minute postexertion measures the fast phase of recovery; normal is a drop of >18 beats per minute by the first minute postexertion. | [107] |
| Abnormal cardiopulmonary exercise testing results | Cardiopulmonary exercise testing may require a referral to a center or office that uses specialized equipment such as a treadmill or bicycle and ECG monitoring, oximetry monitoring, or a mask with flow monitoring. | [108] |
| Dysrhythmias detected on ECG monitoring | Short in office rhythm strips and Holter monitoring can detect dysrhythmia. | [109, 110] |
| Abnormal pulmonary function testing with inclusion of DLCO testing | While chest radiographs and basic pulmonary function testing can be normal, more abnormalities can be detected with inclusion of DLCO testing. | [111] |
Abbreviations: DLCO, diffusing capacity of the lungs for carbon monoxide; ECG, electrocardiogram.
| Abnormal Test . | How to Perform or Order . | References . |
|---|---|---|
| Abnormal NASA Lean Test | After measuring baseline blood pressure and heart rate supine, the patient stands with heels about 6–8 inches from a wall and relaxes and leans against the wall. Record blood pressure, heart rate, and symptoms every minute for 10 minutes (abnormal if heart rate increases >30 beats per minute or rate increases to >120, a decrease in systolic blood pressure of >20, or a decrease in diastolic blood pressure of >10). | [102] |
| Abnormal Sudomotor Assessment | Diagnostic machines are used to perform the QSART or sweat test using electrodes that assess the integrity of small unmyelinated postganglionic sympathetic sudomotor C-fibers. This test may require referral to a practice that provides this testing. | [102] |
| Exaggerated orthostatic blood pressure response on heads-up tilt test | This test is performed at centers with a special table that tilts patients from 0°–30°–45°–70° and records heart rate, blood pressure, and symptoms. Tests are interpreted and results provided for the ordering clinician. | [104] |
| Heart rate variability on 24-hour Holter-ECG monitoring | Obtaining Holter monitoring may require referral to a cardiologist, but in some areas testing can be ordered by primary care providers with provided interpretations. | [105] |
| Abnormal heart rate recovery at 1 minute postexertion | Measuring heart rate at 1 minute postexertion measures the fast phase of recovery; normal is a drop of >18 beats per minute by the first minute postexertion. | [107] |
| Abnormal cardiopulmonary exercise testing results | Cardiopulmonary exercise testing may require a referral to a center or office that uses specialized equipment such as a treadmill or bicycle and ECG monitoring, oximetry monitoring, or a mask with flow monitoring. | [108] |
| Dysrhythmias detected on ECG monitoring | Short in office rhythm strips and Holter monitoring can detect dysrhythmia. | [109, 110] |
| Abnormal pulmonary function testing with inclusion of DLCO testing | While chest radiographs and basic pulmonary function testing can be normal, more abnormalities can be detected with inclusion of DLCO testing. | [111] |
| Abnormal Test . | How to Perform or Order . | References . |
|---|---|---|
| Abnormal NASA Lean Test | After measuring baseline blood pressure and heart rate supine, the patient stands with heels about 6–8 inches from a wall and relaxes and leans against the wall. Record blood pressure, heart rate, and symptoms every minute for 10 minutes (abnormal if heart rate increases >30 beats per minute or rate increases to >120, a decrease in systolic blood pressure of >20, or a decrease in diastolic blood pressure of >10). | [102] |
| Abnormal Sudomotor Assessment | Diagnostic machines are used to perform the QSART or sweat test using electrodes that assess the integrity of small unmyelinated postganglionic sympathetic sudomotor C-fibers. This test may require referral to a practice that provides this testing. | [102] |
| Exaggerated orthostatic blood pressure response on heads-up tilt test | This test is performed at centers with a special table that tilts patients from 0°–30°–45°–70° and records heart rate, blood pressure, and symptoms. Tests are interpreted and results provided for the ordering clinician. | [104] |
| Heart rate variability on 24-hour Holter-ECG monitoring | Obtaining Holter monitoring may require referral to a cardiologist, but in some areas testing can be ordered by primary care providers with provided interpretations. | [105] |
| Abnormal heart rate recovery at 1 minute postexertion | Measuring heart rate at 1 minute postexertion measures the fast phase of recovery; normal is a drop of >18 beats per minute by the first minute postexertion. | [107] |
| Abnormal cardiopulmonary exercise testing results | Cardiopulmonary exercise testing may require a referral to a center or office that uses specialized equipment such as a treadmill or bicycle and ECG monitoring, oximetry monitoring, or a mask with flow monitoring. | [108] |
| Dysrhythmias detected on ECG monitoring | Short in office rhythm strips and Holter monitoring can detect dysrhythmia. | [109, 110] |
| Abnormal pulmonary function testing with inclusion of DLCO testing | While chest radiographs and basic pulmonary function testing can be normal, more abnormalities can be detected with inclusion of DLCO testing. | [111] |
Abbreviations: DLCO, diffusing capacity of the lungs for carbon monoxide; ECG, electrocardiogram.
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