An assessment of fatigue in patients with postural orthostatic tachycardia syndrome

Wise, Shelby; Ross, Amanda; Brown, Abigail; Evans, Meredyth; Jason, Leonard A.

doi:10.1177/1359105315613624

Cited by 14 publications

(16 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Postural tachycardia syndrome, also referred to as postural orthostatic tachycardia syndrome, is a dysautonomia that causes severe disability, 7,8 and is estimated to occur in up to 3,000,000 persons in the United States of America. 9 Despite having been described 25 years ago, 2 little is known about the pathophysiology.…”

Section: Discussionmentioning

confidence: 99%

Family history of associated disorders in patients with postural tachycardia syndrome

Boris¹,

Huang

Shuey³

et al. 2020

Cardiol Young

View full text Add to dashboard Cite

Introduction:Postural tachycardia syndrome is more frequently being recognised in adolescents and adults. However, its pathophysiology remains undefined. We evaluated our database for patterns in family history of clinical symptoms and associated disorders in these patients.Materials and methods:Patients with postural tachycardia syndrome diagnosed in our clinic between 2014 and 2018 and who were less than 19 years at diagnosis were included. The history was reviewed for family members with postural tachycardia syndrome, dizziness and/or syncope, joint hypermobility with or without hypermobile Ehlers–Danlos syndrome, and autoimmune disorders. Statistical analysis assessed the entire cohort plus differences in gender, presence or absence of joint hypermobility, and presence or absence of familial autoimmune disease.Results:A total of 579 patients met inclusion criteria. We found that 14.2% of patients had a family member with postural tachycardia syndrome, with male patients more likely to have an affected family member (20% versus 12.7%, p = 0.04). If the patient also had joint hypermobility, male patients were more likely to have a family member with postural tachycardia syndrome (25% versus 12.6%, p = 0.017), more than one affected family member (7.1% versus 0.74%, p = 0.001), and a family member with joint hypermobility (37.5% versus 23.7%, p = 0.032). Autoimmune disease was seen in 45.1% of family members, but more likely in female patients with concurrent hypermobility (21.1% versus 8.9%, p = 0.035).Discussion:This in-depth analysis of associated familial disorders in patients with postural tachycardia syndrome offers further insight into the pathophysiology of the disorder, and informs further screening of family members in these patients.

show abstract

Section: Discussionmentioning

confidence: 99%

Family history of associated disorders in patients with postural tachycardia syndrome

Boris¹,

Huang

Shuey³

et al. 2020

Cardiol Young

View full text Add to dashboard Cite

show abstract

“…1 3 [34][35][36][37][38][39][40][41], with a further 39% incorporating a case-control design [42][43][44][45][46]. Only three of the included articles reported data on participant race [34,35,40], and only six studies presented the duration of syncope symptoms within their sample [34][35][36][42][43][44][45]. Three studies provided the frequency of recurrent syncope within the population of interest [34,35,41].…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Only three of the included articles reported data on participant race [34,35,40], and only six studies presented the duration of syncope symptoms within their sample [34][35][36][42][43][44][45]. Three studies provided the frequency of recurrent syncope within the population of interest [34,35,41]. All articles identified represented the North American experience, with the exception of two studies examining fatigue in patients with POTS living in the UK.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…In terms of types of fatigue experienced, several studies noted that the presence of brain fog was prevalent in patients with POTS [34,35,42]. Ross et al noted that, in patients with POTS, 96% had experienced brain fog and 67% reported experiencing it daily, with a strong association between fatigue and brain fog [35].…”

Section: Evidence On the Association Between Fatigue And Orthostatic ...mentioning

confidence: 99%

See 1 more Smart Citation

Faintly tired: a systematic review of fatigue in patients with orthostatic syncope

Khan

Hockin

et al. 2022

Clin Auton Res

View full text Add to dashboard Cite

Background Orthostatic syncope (transient loss of conscious when standing—fainting) is common and negatively impacts quality of life. Many patients with syncope report experiencing fatigue, sometimes with “brain fog”, which may further impact their quality of life, but the incidence and severity of fatigue in patients with syncope remain unclear. In this systematic review, we report evidence on the associations between fatigue and conditions of orthostatic syncope. Methods We performed a comprehensive literature search of four academic databases to identify articles that evaluated the association between orthostatic syncope [postural orthostatic tachycardia syndrome (POTS), vasovagal syncope (VVS), orthostatic hypotension (OH)] and fatigue. Studies were independently screened using a multi-stage approach by two researchers to maintain consistency and limit bias. Results Our initial search identified 2797 articles, of which 13 met our inclusion criteria (POTS n = 10; VVS n = 1; OH n = 1; VVS and POTS n = 1). Fatigue scores were significantly higher in patients with orthostatic syncope than healthy controls, and were particularly severe in those with POTS. Fatigue associated with orthostatic syncope disorders spanned multiple domains, with each dimension contributing equally to increased fatigue. “Brain fog” was an important symptom of POTS, negatively affecting productivity and cognition. Finally, fatigue was negatively associated with mental health in patients with POTS. Conclusion In conditions of orthostatic syncope, fatigue is prevalent and debilitating, especially in patients with POTS. The consideration of fatigue in patients with orthostatic disorders is essential to improve diagnosis and management of symptoms, thus improving quality of life for affected individuals.

show abstract

“…10 Furthermore, while both syndromes experience fatigue as a multi-dimensional construct, POTS patients have less distinct fatigue types compared to CFS. 32…”

Section: Potential Mechanisms Underlying Psychological and Cognitimentioning

confidence: 99%

Cognitive and psychological issues in postural tachycardia syndrome

Raj

Opie

Arnold

2018

Autonomic Neuroscience

View full text Add to dashboard Cite

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. The extent of the impact that this cognitive challenge has in patients justifies ongoing investigation and research into lifestyle and pharmacological treatments. Psychologically, patients face challenges congruent with many chronic illnesses, perhaps especially early in adjusting to the condition. POTS patients often exhibit mild to moderate depression symptoms as well as symptoms of anxiety disorders. Since even low levels of anxiety can exacerbate symptoms, and a high number of patients experience sub-clinical low mood and sleep disturbances, there is a likely role for psychotherapy in helping control adjustment-related issues, and possibly aberrant physiology, in POTS.

show abstract

An assessment of fatigue in patients with postural orthostatic tachycardia syndrome

Cited by 14 publications

References 15 publications

Family history of associated disorders in patients with postural tachycardia syndrome

Family history of associated disorders in patients with postural tachycardia syndrome

Faintly tired: a systematic review of fatigue in patients with orthostatic syncope

Cognitive and psychological issues in postural tachycardia syndrome

Contact Info

Product

Resources

About