Orthostatic vitals are measured to diagnose orthostatic hypotension. Hypertension and tachycardia alternating with hypotension and bradycardia may develop. Patients with a history of orthostatic hypotension or severe hepatic impairment. These adverse effects are ventricular dysrhythmia, bradycardia, hypotension and shock. Complications include bradycardia, hypotension, and hypothermia. Heat syncope is related to heat exposure that produces orthostatic hypotension. Taking carvedilol with food decreases the risk of orthostatic hypotension. The adverse effects include lethargy, bradycardia, marked hypotension and loss of consciousness. Midodrine is indicated for the treatment of symptomatic orthostatic hypotension. Expected symptoms include severe hypotension (low blood pressure) and reflex tachycardia. Abnormal growing central venous pressure indicates either hypotension or hypovolemia. The severity of orthostatic hypotension also predicts a worse prognosis. Orthostatic hypotension (or postural hypotension) is a drop in blood pressure upon standing. Pyridostigmine sometimes is used to treat orthostatic hypotension. This causes several adverse effects, including hypotension and cyanosis.