Autonomic Vulnerability and Microvascular Instability: A Hypothesis Linking Sympa-thetic-Parasympathetic Imbalance to Functional Perfusion Disorders
Abstract
Bruce H. Knox
Microvascular dysfunction is increasingly recognised as a contributor to a wide range of clinical conditions including post- viral syndromes, chronic fatigue states, gastrointestinal dysmotility, and unexplained chest pain syndromes. However, structural vascular abnormalities are often absent, leaving the mechanistic basis of these conditions uncertain.
This hypothesis paper proposes that microvascular instability may represent a downstream physiological consequence of autonomic vulnerability, particularly following severe cardiovascular insult or viral autonomic injury. In this framework, persistent sympathetic–parasympathetic imbalance alters microvascular tone regulation, leading to unstable perfusion dynamics across multiple organ systems.
