True about autonomic neuropathy are all except :
Bradyardia This is a question about cardiovascular features of autonomic neuropathy. Cardiovascular feature of autonomic neuropathy i) Resting hea rate (after 15 minutes of rest) of 100 beatim or more i.e. (resting tachycardia) ii) Lack of beat to beat variability on electrocardiographic recordings < 10 beats/min iii) A ratio of the longest R-R interval to the shoest of 1.10 or less during valsalva maneuver. iv) A ratio of the R-R interval of the 30th beat to the 15th after standing of 1 minute or less. v) A fall in systolic blood pressure of 30 mm Hg or more after 1 minutes of standing (ohostatic 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.1) Clinical signs of autonomic neuropathy Hypeension Painless myocardial ischemia Ohostatic hypotension Lack of hea rate variability Reduced hea rate response to atropine and propranolol Resting tachycardia Early satiety Neurogenic bladder Lackof sweating Impotence (early dysfunction) Gastroparesis
Resting tachycardia
Silent MI
Ohostatic hypotension
Bradyardia