True about autonomic neuropathy are all except:
Ans. is 'd' i.e. Bradycardia This is a question about cardiovascular features of autonomic neuropathy. The cardiovascular feature of autonomic neuropathy Resting heart rate (after 15 minutes of rest) of 100 beat/m or more i.e. (resting tachycardia) Lack of beat to beat variability on electrocardiographic recordings <10 beats/min A ratio of the longest R-R interval to the shortest of 1.10 or less during Valsalva maneuver. A ratio of the R-R interval of the 30 th beat to the 15 th after standing of 1 minute or less. A fall in systolic blood pressure of 30 mm Hg or more after 1 minutes of standing (orthostatic hypotension) Painless M.I. in autonomic neuropathy Pain of the angina is mediated through sympathetic fibres In autonomic neuropathy the autonomic fibres (the sympathetic and parasympathetic fibres) are damaged so they will not be able to transmit the pain and thus there will be painless M.I. (silent M.I.) Clinical signs of autonomic neuropathy Hypertension Painless myocardial ischemia Orthostatic hypotension Lack of heart rate variability Reduced heart rate response to atropine and propranolol Resting tachycardia Early satiety Neurogenic bladder Lack of sweating Impotence (early dysfunction) Gastroparesis
Resting tachycardia
Silent MI
Orthostatic hypotension
Bradycardia