Abstract
Cardiac autonomic neuropathy is one of the microvascular complications of diabetes mellitus. It affects up to one fifth of diabetic patients.
The cardiac autonomic neuropathy diagnosis is associated with a 5-fold increase of mortality, higher prevalence of silent myocardial ischemia, systolic and diastolic left ventricular dysfunction. Patients with cardiovascular autonomic neuropathy have increased risk of anaesthesia-associated complications, higher perioperative morbidity and mortality.
The major clinical manifestations of cardiovascular autonomic neuropathy include resting tachycardia, postural and postprandial hypotension, and exercise intolerance. The diagnosis cannot be determined by the presence of symptoms but the cardiovascular autonomic reflex tests must be performed.
The therapy should be focused on the optimal diabetic control as well as on the interference of general cardiovascular risk factors.