Autonomic Nervous System (ANS) testing is a powerful diagnostic tool to assess communication from the brain to various organs such as the heart & vascular system, lungs, kidneys, stomach, liver, intestines & digestive system. ANS testing is deemed medically appropriate across a variety of medical specialties including internal medicine, cardiology, neurology, endocrinology, rheumatology, pain management and general medicine. It is well established that healthy autonomic activity & maintaining autonomic balance reduces (or prolongs) complications of chronic disease and reduces mortality & morbidity.
Autonomic Nervous System (ANS) testing is a simple test that lasts anywhere from 7 – 15 minutes depending on the model of the system. ANS testing is based on Heart Rate Variability (HRV) which (in its simplest form) monitors the R-R intervals, beat by beat blood pressure and pulse wave form throughout all segments of the test. The general concept is for the patient to perform a series of maneuvers while the ANS system monitors the body’s response. The system looks at changes in heart rate & blood pressure to calculate response as well as autonomic balance in both branches of the autonomic nervous system – the parasympathetic & sympathetic nervous systems.
Autonomic Nervous System (ANS) Testing Provides:
- Quantitative assessments of the autonomic nervous system (ANS)
- Distinguishes between early and late stages of autonomic neuropathy
- Explain responses to changes in environmental conditions
- Manage symptoms that result from abnormal autonomic functions
- Test for cardiovascular autonomic neuropathy (CAN)
- Assess risk of sudden cardiac death
- Test for diabetic autonomic neuropathy (DAN)
- Origin of syncope
- Origin of dizziness
- Assess patient response to pharmacological therapies
- Monitor beta-blocker regime to assess sympathetic response
- Distinguish between early and late stages of autonomic dysfunction
- Helps monitor patients’ overall health
- Other autonomic disorders
Patients to Consider for Autonomic Nervous System (ANS) testing:
- Patients with Symptoms Suggesting Autonomic Dysfunction
- Syncope
- Orthostatic Hypotension
- Postural Tachycardia Syndrome (POTS)
- Pain / numbness in feet
- Numbness in hands
- Cardio Metabolic Syndrome
- Cardiac patients with silent ischemia
- Diabetic patients
- Pre-diabetic patients
- Impaired glucose tolerance
- Insulin resistance
- Blood pressure disorders
- Resting tachycardia
- Congestive heart failure
- Sleep Apnea
- Chronic pain in extremities
- Digestive disorders
- Patients with chronic inflammation
- Rheumatoid Arthritis
Details of Autonomic Nervous System (ANS) Testing
Autonomic Nervous System (ANS) testing has a standardized and specific protocol established for acquiring reliable and accurate results. Autonomic Nervous System (ANS) testing can be tolerated by most patients as there are specific maneuvers required to be performed throughout the test. The test includes 4 sections. These sections include:
- Resting heart rate, blood pressure & pulse (arterial) waveform
- Valsalva Maneuver
- Deep breathing
- Response to postural change (sitting to standing)
Frequency of Autonomic Nervous System (ANS) Testing
Autonomic Nervous System (ANS) testing is deemed reasonable and necessary in patients at the onset of symptoms, suspected onset of disease and with patients diagnosed with chronic diseases. Autonomic Nervous System testing can be administered once per year or repeat testing can be performed when medically necessary. Repeat testing can be done to assess patient response to medical therapy, assess disease progression or to be used in conjunction with results found from other standard diagnostic testing.
Autonomic Nervous System (ANS) testing is covered by Medicare and most private insurance companies.
ANS FAQs
Autonomic testing helps find out if your autonomic nervous system (ANS) is working as well as it should. Your ANS controls body functions that happen automatically (without you thinking about them). These include breathing, heartbeat, body temperature, and digestion.
Your physician may recommend autonomic testing if you’re experiencing symptoms including:
- Abnormal sweating
- Dizziness
- Fainting
- Fatigue
- Fluctuating blood pressure
- Numbness and burning in your hands or feet
- Rapid heart rate
- Shortness of breath
Autonomic testing is an umbrella term that covers testing of the various branches of the nervous system: the sympathetic, parasympathetic, and enteric. It should be noted that the autonomic nervous system extends to nearly every organ system in the body; so many organ specific tests are in fact tests of autonomic function (such as urodynamic).
The most common symptoms that are caused by a dysfunction of the autonomic nervous system are lightheadedness and dizziness or fainting episodes. There can be other symptoms like the sensation that your heart is beating far too fast especially on standing up. These symptoms primarily occur in the standing up position.