Postural Orthostatic Tachycardia Syndrome

Safavi‐Naeini, Payam; Razavi, Mehdi

doi:10.14503/thij-19-7060

Cited by 15 publications

(17 citation statements)

References 14 publications

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“…This increase in HR is way higher than the increase in HR of negative and syncopal outcome. Impaired vascular innervation, high plasma norepinephrine concentrations, α-receptor sensitivity, deconditioning, hypovolemia, [20] β-receptor hypersensitivity, [21] and baroreceptor dysfunction [22] have been attributed to reasons behind increase in HR. Low blood volume has been reported in the literature as one of the major causes of POTS.…”

Section: Discussionmentioning

confidence: 99%

Analysis of cardiovascular responses to head-up tilt testing

Kaur

Sinha

Raju

2020

IJAM

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Introduction: Head-up tilt (HUT) testing is a widely accepted tool in the clinical evaluation of patients presenting with episodic loss of consciousness. The test has assumed its importance in aviation environment, where a single episode of unconsciousness in-flight may have a catastrophic outcome. To rule out this, HUT is carried out in all cases of syncope as a part of aeromedical evaluation. The present study was undertaken to analyze the CVS response to HUT conducted over a period of 11 years at the Department of Space and Environmental Physiology at the Institute of Aerospace Medicine. Material and Methods: A total of 168 subjects had undergone HUT testing from 2002 to 2012. The testing equipment was a standard tilt table with a foot board support for the feet and restraint system at the level of chest, waist, and ankle to support the body during tilting. The testing protocol consisted of passive tilting to an angle of 70° from the horizontal position for 45 min in all the cases. The physiological parameters consisting of heart rate (HR) and blood pressure from the database were analyzed to understand the CVS response to HUT. Results: Out of the total 168 patients, 147 (88.5%) cases showed normal response. Twenty-one (12.5%) cases showed abnormal response. Out of the cases showing abnormal response, 14 cases had syncope with frank loss of consciousness and could not maintain the postural tone. The remaining seven cases showed postural orthostatic tachycardia syndrome (POTS), where the HR increased by more than 30 beats per minute. Conclusion: A retrospective analysis of 168 cases with history of syncope, in a period of 11 years, revealed an abnormal cardiovascular response to HUT in 12.5% of cases. The abnormal physiological responses were mostly consistent with syncope and POTS.

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Section: Discussionmentioning

confidence: 99%

Analysis of cardiovascular responses to head-up tilt testing

Kaur

Sinha

Raju

2020

IJAM

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“…Other contributing factors are reduced cardiac output, postprandial blood pooling, insulin-induced hypotension and volume depletion due to diuretics[ 64 ]. Patients can sometimes present with postural orthostatic tachycardia syndrome, which is characterised by the presence of orthostatic symptoms occurring on standing, an increase in heart rate of ≥ 30 beats/minute when moving from a recumbent to a standing position that lasts more than 30 seconds and the absence of orthostatic hypotension (more than 20 mmHg drop in systolic blood pressure)[ 65 ].…”

Section: Dm and Canmentioning

confidence: 99%

Diabetic heart disease: A clinical update

Rajbhandari¹,

Fernandez²,

Agarwal³

et al. 2021

WJD

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Diabetes mellitus (DM) significantly increases the risk of heart disease, and DM-related healthcare expenditure is predominantly for the management of cardiovascular complications. Diabetic heart disease is a conglomeration of coronary artery disease (CAD), cardiac autonomic neuropathy (CAN), and diabetic cardiomyopathy (DCM). The Framingham study clearly showed a 2 to 4-fold excess risk of CAD in patients with DM. Pathogenic mechanisms, clinical presentation, and management options for DM-associated CAD are somewhat different from CAD among nondiabetics. Higher prevalence at a lower age and more aggressive disease in DM-associated CAD make diabetic individuals more vulnerable to premature death. Although common among diabetic individuals, CAN and DCM are often under-recognised and undiagnosed cardiac complications. Structural and functional alterations in the myocardial innervation related to uncontrolled diabetes result in damage to cardiac autonomic nerves, causing CAN. Similarly, damage to the cardiomyocytes from complex pathophysiological processes of uncontrolled DM results in DCM, a form of cardiomyopathy diagnosed in the absence of other causes for structural heart disease. Though optimal management of DM from early stages of the disease can reduce the risk of diabetic heart disease, it is often impractical in the real world due to many reasons. Therefore, it is imperative for every clinician involved in diabetes care to have a good understanding of the pathophysiology, clinical picture, diagnostic methods, and management of diabetes-related cardiac illness, to reduce morbidity and mortality among patients. This clinical review is to empower the global scientific fraternity with up-to-date knowledge on diabetic heart disease.

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“…11 This subtype also demonstrates multiple other symptoms attributable to sympathetic activation including palpitations, tachycardia, tremor, and anxiety. 18 This may also have an autoimmune basis as sera obtained from patients with POTS have been found to increase β-1 and β-2 adrenoceptor activation. [15][16][17]…”

Section: Hyperadrenergic Potsmentioning

confidence: 99%

Postural Tachycardia Syndrome: Nutrition Implications

2020

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Postural tachycardia syndrome (POTS) is a syndrome characterized by elevated heart rate without hypotension and most commonly occurs in young females (generally <35 years of age). The prevalence of POTS is on the rise, but the etiology is still under investigation, and there appear to be multiple potential physiologic causes. The majority of these patients experience a multitude of gastrointestinal (GI) and systemic symptoms and conditions that may contribute to functional debility and poor quality of life. Although symptoms generally improve with age, they can still lead to significant issues meeting nutrition and hydration needs. This paper summarizes the understood potential pathophysiology of POTS, associated GI and nutrition issues, general treatment of POTS, and strategies to assess and meet the unique nutrition and hydration needs of these patients.

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Postural Orthostatic Tachycardia Syndrome

Cited by 15 publications

References 14 publications

Analysis of cardiovascular responses to head-up tilt testing

Analysis of cardiovascular responses to head-up tilt testing

Diabetic heart disease: A clinical update

Postural Tachycardia Syndrome: Nutrition Implications

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