Dr. Ayyaz Sultan

Scope of Assessment – Post-Traumatic Dysautonomia

Dr Sultan assesses patients for post-traumatic dysautonomia, including PoTS and orthostatic intolerance, where symptoms are reported following trauma, such as road traffic accidents (RTA) or whiplash (acceleration–deceleration) injuries.

His assessments focus on symptoms post RTA or whiplash injury consistent with autonomic dysfunction, including (its impact on life, linkage/association etc):

• Fatigue and chronic fatigue
• Shortness of breath (air hunger)
• Headaches (including postural or “coat-hanger” type)
• Dizziness and presyncope
• Chest pain (non-ischaemic)
• Palpitations
• Exercise intolerance
• Symptoms overlapping with fibromyalgia and chronic fatigue syndromes

These symptoms are evaluated in the context of clinical chronology, physiological plausibility, and available investigations, to determine whether they are consistent with post-traumatic dysautonomia.

Important Scope Clarification

Dr Sultan accepts cases where there is a history of:

• Road traffic accidents (RTA)
• Whiplash or acceleration–deceleration injuries

However, his medico-legal opinion is strictly limited to autonomic dysfunction.

He does not provide expert opinion on the primary injury itself, including:

• Cervical spine trauma
• Head and neck injury
• Orthopaedic or structural injury diagnosis

His role is to assess whether dysautonomia symptoms are present and whether they are plausibly related to the reported traumatic event, rather than to diagnose or comment on the underlying structural injuries.

Royal College of Physicians (UK); British Cardiovascular Society; British Cardiovascular Intervention Society; European Association of Percutaneous Cardiovascular Interventions; American Heart Association