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Postural orthostatic tachycardia syndrome

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https://www.readbyqxmd.com/read/29909001/-postural-tachycardia-syndrome-pots-an-up-to-date
#1
L Astudillo, A Laure, V Fabry, G Pugnet, P Maury, M Labrunée, L Sailler, A Pavy-Le Traon
Postural tachycardia syndrome (PoTS) is a multifactorial syndrome defined by an increase in heart rate ≥30bpm, within 10minutes of standing (or during a head up tilt test to at least 60°), in absence of orthostatic hypotension. It is associated with symptoms of cerebral hypoperfusion that are worse when upright and improve in supine position. Patients have an intense fatigue with a high incidence on quality of life. This syndrome can be explained by many pathophysiological mechanisms. It can be associated with Ehlers-Danlos disease and some autoimmune disorders...
June 13, 2018: La Revue de Médecine Interne
https://www.readbyqxmd.com/read/29904895/syncope-and-headache
#2
REVIEW
Ramesh K Khurana
PURPOSE OF REVIEW: We review the literature on co-occurrence of syncope and headache and share clinical experience. RECENT FINDINGS: Headache in relation to syncope has been the subject of recent interest. Orthostatic intolerance has an expanding spectrum with three well-defined entities: orthostatic hypotension (OH), neurally mediated hypotension (NMH), and postural tachycardia syndrome (PoTS). Syncope occurs in patients with OH as well as in patients with episodically occurring NMH...
June 15, 2018: Current Pain and Headache Reports
https://www.readbyqxmd.com/read/29903594/the-patient-perspective-what-postural-orthostatic-tachycardia-syndrome-patients-want-physicians-to-know
#3
REVIEW
Lauren E Stiles, Jaclyn Cinnamon, Irina Balan
Diagnosing and treating postural orthostatic tachycardia syndrome (POTS) can be a frustrating experience for patients and physicians alike. Experienced patient leaders solicited input from the large online POTS community to identify patient suggestions and concerns, with the goal of improving the patient-physician relationship and outcomes in POTS. This review article offers practical tips to improve POTS patient care and links to credible resources for your patients. The authors emphasize the urgent need for improved physician education, a tailored treatment approach, and expanded research efforts...
June 7, 2018: Autonomic Neuroscience: Basic & Clinical
https://www.readbyqxmd.com/read/29886470/-comparison-of-curative-effect-and-serum-electrolytes-between-different-oral-rehydration-salts-in-treatment-of-neurally-mediated-syncope-children
#4
Wenhua Zhang, Runmei Zou, Yi Xu, Cheng Wang
To compare the curative effect and the changes of serum electrolytes between oral rehydration salts (ORS) I and ORS III treatment in neurally mediated syncope children.
 Methods: The children with the symptom of unexplained syncope and pre-syncope were collected in Second Xiangya Hospital from May 2014 to May 2017. After head-up tilt test (HUTT), their serum electrolytes levels were examined. Children who were positive in the HUTT received ORS (ORS I or ORS III) and health education. Subjects were randomly divided into an ORS I group (n=27) and an ORS III group (n=49)...
May 28, 2018: Zhong Nan da Xue Xue Bao. Yi Xue Ban, Journal of Central South University. Medical Sciences
https://www.readbyqxmd.com/read/29876157/postural-orthostatic-tachycardia-syndrome-and-its-unusual-presenting-complaints-in-women-a-literature-minireview
#5
REVIEW
Ibrar Anjum, Wafa Sohail, Betul Hatipoglu, Robert Wilson
Postural orthostatic tachycardia syndrome (POTS) is a heterogeneous disorder of the autonomic nervous system that is defined by symptoms of orthostatic intolerance. According to the current criteria for adults, currently, POTS is defined as a heart rate increment of 30 beats/minute or more after 10 minutes of standing in the absence of orthostatic hypotension. There is a vast majority that remains misdiagnosed due to the heterogeneity of the disorder. Due to a lack of Food and Drug Administration (FDA) approved therapy, alternative therapies and over the counter medications are used to alleviate the symptoms...
April 5, 2018: Curēus
https://www.readbyqxmd.com/read/29864098/activity-and-exercise-intolerance-after-concussion-identification-and-management-of-postural-orthostatic-tachycardia-syndrome
#6
Nicole A Miranda, Jeffrey R Boris, Kristen M Kouvel, Lauren Stiles
BACKGROUND AND PURPOSE: Postural orthostatic tachycardia syndrome (POTS) is increasingly recognized as a complication affecting recovery from concussion. Individuals with POTS demonstrate refractory dizziness, lightheadedness, cognitive dysfunction, fatigue, headache, chronic pain, nausea and gastrointestinal dysmotility, activity and exercise intolerance, syncope, and tachycardia. Subtypes of POTS may include hypovolemia, hyperadrenergic states, autonomic neuropathy, and underlying autoimmunity, which may variably impact response to rehabilitation in varying ways...
June 1, 2018: Journal of Neurologic Physical Therapy: JNPT
https://www.readbyqxmd.com/read/29850268/postural-tachycardia-syndrome-and-vasovagal-syncope-a-hidden-case-of-obstructive-cardiomyopathy-without-severe-septal-hypertrophy
#7
Kenneth A Mayuga, Natalie Ho, Robert W Shields, Paul Cremer, L Leonardo Rodriguez
A 36-year-old female with symptoms of orthostatic intolerance and syncope was diagnosed with vasovagal syncope on a tilt table test and with postural tachycardia syndrome (POTS) after a repeat tilt table test. However, an echocardiogram at our institution revealed obstructive cardiomyopathy without severe septal hypertrophy, with a striking increase in left ventricular outflow tract gradient from 7 mmHg at rest to 75 mmHg during Valsalva, with a septal thickness of only 1.3 cm. Cardiac MRI showed an apically displaced multiheaded posteromedial papillary muscle with suggestion of aberrant chordal attachments to the anterior mitral leaflet contributing to systolic anterior motion of the mitral valve...
2018: Case Reports in Cardiology
https://www.readbyqxmd.com/read/29801880/orthostatic-tachycardia-with-different-onset-time-in-patients-with-orthostatic-intolerance
#8
Hyung Lee, Hyun Ah Kim
OBJECTIVE: To investigate whether there is a difference in the neuro-autonomic and hemodynamic parameters in patients with postural tachycardia syndrome (POTS) according to onset time of orthostatic tachycardia during the Head-up tilt (HUT) test. METHODS: We retrospectively reviewed neuro-autonomic and hemodynamic data from patients with orthostatic intolerance. A standardized battery of neuro-autonomic tests, including the HUT, Valsalva maneuver, heart rate deep breathing and quantitative sudomotor axon reflex test, was performed...
July 15, 2018: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/29784553/postural-orthostatic-tachycardia-syndrome-during-pregnancy-a-systematic-review-of-the-literature
#9
REVIEW
Kate Morgan, Catherine Chojenta, Meredith Tavener, Angela Smith, Deb Loxton
PURPOSE: Postural Orthostatic Tachycardia Syndrome is most commonly seen in women of child bearing age, however little is known about its effects in pregnancy. METHOD: A systematic review was conducted in March 2015 and updated in February 2018. Medline, Embase, PsychInfo, CINHAL, and the Cochrane Library were searched from database inception. The ClinicalTrials.gov site and bibliographies were searched. MeSH and Emtree headings and keywords included; Postural Orthostatic Tachycardia Syndrome, Postural Tachycardia Syndrome, and were combined with pregnancy and pregnancy related subject headings and keywords...
May 9, 2018: Autonomic Neuroscience: Basic & Clinical
https://www.readbyqxmd.com/read/29778304/postural-orthostatic-tachycardia-syndrome-in-children-and-adolescents
#10
REVIEW
Jeffrey R Boris
Postural orthostatic tachycardia syndrome (POTS) affects up to 3,000,000 people in the United States, with at least one-third of them developing POTS before the age of 18. POTS as a disorder is similar in adult and pediatric populations, but there are factors specific to pediatric patients that affect how it presents and how it is experienced that make pediatric POTS different. This review discusses the both the similarities in this population to their adult counterparts and the unique challenges faced by pediatric POTS patients, including management of schooling and education as well as the complex interactions between these pediatric patients and their parents...
May 12, 2018: Autonomic Neuroscience: Basic & Clinical
https://www.readbyqxmd.com/read/29753556/pharmacotherapy-for-postural-tachycardia-syndrome
#11
REVIEW
Amanda J Miller, Satish R Raj
Postural tachycardia syndrome (POTS) is a disorder characterized by the presence of orthostatic symptoms (including lightheadedness, palpitations, nausea, dyspnea, and tremulousness) as well as excessive upright tachycardia. POTS predominantly affects women of childbearing age. Treating POTS involves a multi-faceted approach using non-pharmacological and pharmacological interventions. There are no pharmacological treatments that are currently United States Food and Drug Administration (FDA) approved for POTS due to lack of randomized controlled trials...
May 4, 2018: Autonomic Neuroscience: Basic & Clinical
https://www.readbyqxmd.com/read/29705015/evaluation-of-postural-tachycardia-syndrome-pots
#12
REVIEW
Brent P Goodman
The diagnostic evaluation of a patient with suspected postural tachycardia syndrome (POTS) requires a thoughtful diagnostic approach utilizing a careful clinical history and examination, laboratory, and autonomic testing. This article outlines the importance of a thorough history in identifying mechanism of symptom onset, clinical features, associated clinical conditions or disorders, and factors that may result in symptom exacerbation. The clinical examination involves an assessment of pupillary responses, an evaluation for sudomotor and vasomotor signs, and an assessment for joint hypermobility...
April 22, 2018: Autonomic Neuroscience: Basic & Clinical
https://www.readbyqxmd.com/read/29701190/-relationship-between-unexplained-palpitation-in-children-and-head-up-tilt-test
#13
Tuoyu Gan, Lijia Wu, Runmei Zou, Ping Lin, Fang Li, Hong Yang, Ping Liu, Xiaohui Gong, Cheng Wang
To explore the relationship between unexplained palpitation in children and head-up tilt test (HUTT).
 Methods: A total of 142 children with the main symptom of unexplained palpitation were admitted to the Specialist Out-Patient Clinic of Children's Cardiovascular Disease from Sept. 2008 to Feb. 2017 in the Second Xiangya Hospital, Central South University. Among them, 63 cases were male, 79 cases were female, with the mean age of (10.12±2.88) years old. The detailed history, physical examinations, conventional 12 electrocardiogram, chest X-ray, echocardiography, myocardial enzymes and thyroid function were all examined...
March 28, 2018: Zhong Nan da Xue Xue Bao. Yi Xue Ban, Journal of Central South University. Medical Sciences
https://www.readbyqxmd.com/read/29696346/orthostatic-intolerance-and-postural-tachycardia-syndrome-new-insights-into-pathophysiology-and-treatment
#14
REVIEW
Mohammed Ruzieh, Blair P Grubb
Orthostatic intolerance is characterized by symptoms of light-headedness or syncope that is provoked upon standing or in an upright posture. It is most commonly caused by postural orthostatic tachycardia syndrome (POTS) or orthostatic hypotension (OH). Its pathophysiology is complex and commonly involves abnormal autonomic nervous system regulation, autoimmunity, a hyperadrenergic state, and hypovolemia. This article reviews the pathophysiology underlying orthostatic intolerance, as well as the current treatment available...
June 2018: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/29687025/autoimmune-postural-orthostatic-tachycardia-syndrome
#15
Mari Watari, Shunya Nakane, Akihiro Mukaino, Makoto Nakajima, Yukiko Mori, Yasuhiro Maeda, Teruaki Masuda, Koutaro Takamatsu, Yanosuke Kouzaki, Osamu Higuchi, Hidenori Matsuo, Yukio Ando
The aim of this study was to evaluate the association between postural orthostatic tachycardia syndrome (POTS) and circulating antiganglionic acetylcholine receptor (gAChR) antibodies. We reviewed clinical assessments of Japanese patients with POTS, and determined the presence of gAChR antibodies in serum samples from those patients. Luciferase immunoprecipitation systems detected anti-gAChR α 3 and β 4 antibodies in the sera from POTS (29%). Antecedent infections were frequently reported in patients in POTS patients...
April 2018: Annals of Clinical and Translational Neurology
https://www.readbyqxmd.com/read/29682372/from-postural-orthostatic-tachycardia-syndrome-to-radiologically-isolated-syndrome
#16
Richa Tripathi, Evanthia Bernitsas
Background: Autonomic dysfunction is common in Multiple Sclerosis (MS) patients. Most spinal cord lesions entail some degree of autonomic nervous system dysfunction. MS patients may develop autonomic dysfunction later in their disease course. Methods: We report a patient with no prior history of MS presenting with orthostatic symptoms and diagnosed initially with postural orthostatic tachycardia syndrome (POTS). Four months later, she was diagnosed with radiologically isolated syndrome (RIS)...
2018: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/29628432/cognitive-and-psychological-issues-in-postural-tachycardia-syndrome
#17
REVIEW
Vidya Raj, Morwenna Opie, Amy C Arnold
Postural tachycardia syndrome (POTS) is one of the most common forms of chronic orthostatic intolerance. In addition to orthostatic symptoms, many POTS patients report incapacitating cognitive dysfunction or "brain fog" even while lying down or seated. Consistent with these subjective reports, there is accruing objective evidence of specific cognitive difficulties in POTS, with studies showing mild to moderate cognitive impairment using standardized neuropsychological assessment batteries. The precise profile of cognitive dysfunction in POTS patients has been shown to vary among these studies potentially due to the neuropsychological tests used, postural position, comorbidities and length of illness, inclusion of adolescent versus adult patients, and sites of recruitment...
March 27, 2018: Autonomic Neuroscience: Basic & Clinical
https://www.readbyqxmd.com/read/29618472/angiotensin-ii-type-1-receptor-autoantibodies-in-postural-tachycardia-syndrome
#18
Xichun Yu, Hongliang Li, Taylor A Murphy, Zachary Nuss, Jonathan Liles, Campbell Liles, Christopher E Aston, Satish R Raj, Artur Fedorowski, David C Kem
BACKGROUND: Both the adrenergic and renin-angiotensin systems contribute to orthostatic circulatory homeostasis, which is impaired in postural orthostatic tachycardia syndrome (POTS). Activating autoantibodies to the α1-adrenergic and β1/2-adrenergic receptors have previously been found in sera from patients with POTS. We hypothesized that patients with POTS might also harbor activating autoantibodies to the angiotensin II type 1 receptor (AT1R) independently of antiadrenergic autoimmunity...
April 4, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29588088/the-etiologic-relation-between-disequilibrium-and-orthostatic-intolerance-in-patients-with-myalgic-encephalomyelitis-chronic-fatigue-syndrome
#19
Kunihisa Miwa, Yukichi Inoue
BACKGROUND: Orthostatic intolerance (OI) causes a marked reduction in the activities of daily living in patients with myalgic encephalomyelitis (ME) or chronic fatigue syndrome. Most symptoms of OI are thought to be related to cerebral hypo-perfusion and sympathetic activation. Because postural stability is an essential element of orthostatic tolerance, disequilibrium may be involved in the etiology of OI. METHODS AND RESULTS: The study comprised 44 patients with ME (men, 11 and women, 33; mean age, 37±9 years), who underwent neurological examinations and 10-min standing and sitting tests...
March 24, 2018: Journal of Cardiology
https://www.readbyqxmd.com/read/29530592/postural-orthostatic-tachycardia-syndrome-pots-in-denmark-increasingly-recognized-or-new-epidemic
#20
Louise Brinth, Kirsten Pors, Jasmina Medic Spahic, Richard Sutton, Artur Fedorowski, Jesper Mehlsen
AIMS: The incidence of Postural Orthostatic Tachycardia Syndrome (POTS) has grown in recent years. Whether this is an emerging epidemic or increasing recognition is unclear. METHODS: We retrospectively examined 8790 tilt-table tests (HUT) performed between 1997 and 2014 in patients with orthostatic intolerance and/or suspected syncope. Tests were reclassified according to the current diagnostic criteria for POTS. The number of POTS diagnoses in proportion to the number of tilt tests performed per year was calculated...
March 3, 2018: Autonomic Neuroscience: Basic & Clinical
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