Management of Postural Tachycardia Syndrome, Inappropriate Sinus Tachycardia and Vasovagal Syncope

Raj, Satish R.; Sheldon, Robert S.

doi:10.15420/aer.2016.7.2

Cited by 17 publications

(9 citation statements)

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“…POTS can be associated with significant morbidity, poor sleep quality and diminished quality of life [6][7][8]. There is no single treatment that can 'cure' a patient of symptoms [9]. A multidisciplinary approach to treatment is often needed [9].…”

Section: Introductionmentioning

confidence: 99%

The face of postural tachycardia syndrome – insights from a large cross‐sectional online community‐based survey

et al. 2019

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Background Patients with postural tachycardia syndrome (POTS) experience chronic symptoms of orthostatic intolerance. There are minimal data detailing the demographics, clinical features and clinical course of this condition. This online, community‐based survey highlights patients’ experience with POTS. It consists of the largest sample of POTS patients reported to date. Objectives To describe the demographics, past medical history, medications, treatments and diagnostic journey for patients living with POTS. Methods Postural tachycardia syndrome patients completed an online, community‐based, cross‐sectional survey. Participants were excluded if they had not received a diagnosis of POTS from a physician. The questions focused on the patient experience and journey, rather than physiological responses. Results The final analysis included 4835 participants. POTS predominantly affects white (93%) females (94%) of childbearing age, with approximately half developing symptoms in adolescence (mode 14 years). POTS is a chronic multisystem disorder involving a broad array of symptoms, with many patients diagnosed with comorbidities in addition to POTS. POTS patients often experience lengthy delays [median (interquartile range) 24 (6–72) months] and misdiagnosis, but the diagnostic delay is improving. POTS patients can present with a myriad of symptoms most commonly including lightheadedness (99%), tachycardia (97%), presyncope (94%), headache (94%) and difficulty concentrating (94%). Conclusions These data provide important insights into the background, clinical features and diagnostic journey of patients suffering from POTS. These data should serve as an essential step for moving forward with future studies aimed at early and accurate diagnoses of these patients leading to appropriate treatments for their symptoms.

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Section: Introductionmentioning

confidence: 99%

The face of postural tachycardia syndrome – insights from a large cross‐sectional online community‐based survey

et al. 2019

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“…Several mechanisms for POTS have been described, including autonomic denervation, deconditioning, hypovolemia, hyperadrenergic stimulation, and hypervigilance. 6 Different mechanisms may coexist in some patients.…”

Section: Pathophysiology and Subtypesmentioning

confidence: 99%

Postural Orthostatic Tachycardia Syndrome

Safavi‐Naeini¹,

Razavi²

2020

Texas Heart Institute Journal

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he term postural orthostatic tachycardia syndrome (POTS) was first used by a team of researchers from Mayo Clinic led by neurologist Philip Low, in 1993. 1 However, the disorder was not new; over the last 160 years, it has been known by many different names, such as neurocirculatory asthenia, orthostatic tachycardia, and orthostatic intolerance. 2 Patients with POTS can be misdiagnosed as having severe anxiety, panic disorder, or chronic fatigue syndrome, because of their similar clinical features. 3

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“…Symptoms of orthostatic Hypovolemia occurs in up to 70% of patients intolerance tend to be exacerbated by dehydration, heat, alcohol, exercise, and menstruation. 36,37 Consider the family history: 1 in 8 patients with POTS reports familial orthostatic intolerance, 38 suggesting a genetic role in some patients. Inquire about symptoms or a previous diagnosis of Ehlers-Danlos syndrome and mast cell activation syndrome.…”

Section: Detailed History Symptom Reviewmentioning

confidence: 99%

Evaluating and managing postural tachycardia syndrome

Lei

Chew

Sheldon

et al. 2019

CCJM

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Postural tachycardia syndrome (POTS) is a disorder of the autonomic nervous system with many possible causes, characterized by an unexplained increase in heartbeat without change in blood pressure upon standing. Associated cardiac and noncardiac symptoms can severely affect quality of life. Therapy, using a combined approach of diet and lifestyle changes, plus judicious use of medications if needed, can usually improve symptoms and function. KEY POINTSSeveral POTS subtypes have been recognized, including hypovolemic, neuro pathic, and hyperadrenergic forms, overlapping with Ehlers-Danlos syndrome, mast cell activation, and autoimmune syndromes.Treatment should take a graded approach, beginning with increasing salt and water intake, exercise, and compression stockings.If needed, consider medications to expand blood volume, slow heart rate, or reduce central sympathetic tone.Certain medications, including venodilators, diuretics, and serotonin-norepinephrine reuptake inhibitors, can exacerbate symptoms and should be avoided.

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Management of Postural Tachycardia Syndrome, Inappropriate Sinus Tachycardia and Vasovagal Syncope

Cited by 17 publications

References 75 publications

The face of postural tachycardia syndrome – insights from a large cross‐sectional online community‐based survey

The face of postural tachycardia syndrome – insights from a large cross‐sectional online community‐based survey

Postural Orthostatic Tachycardia Syndrome

Evaluating and managing postural tachycardia syndrome

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