Postural Orthostatic Tachycardia Syndrome and Its Unusual Presenting Complaints in Women: A Literature Minireview

Abstract

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. This is an uncommon presentation observed primarily in women, as it is more prevalent in females.

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“…8 It can present with presyncopal signs and symptoms such as a headache, lightheadedness, blurring of vision, diaphoresis, nausea and vomiting followed by syncope. The post-syncopal period may have nausea, persistent headache, lightheadedness, dizziness or drowsiness but confusion is uncommon 14. Our patient, however, has with no medical history of nausea, dizziness, drowsiness or other symptoms of POTS and had sudden but unprovoked transient syncope with occasional palpitations on assuming upright posture.…”

“…The pattern of heart rate and blood pressure fluctuations on 70° head-up tilt table test can distinguish among various types of orthostatic intolerance. The physiologic response to head up tilt test in a healthy individual is up to 15 bpm in heart rate and <20 mm Hg drop in blood pressure after 10 min of head tilt while the patients with underlying POTS shows higher resting supine heart rate and ≥30 bpm rise in heart rate and blood pressure is usually unchanged on 1–10 min of head tilt as compared with VVS 14…”

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“…Postural orthostatic tachycardia syndrome (POTS) is defined as a heart rate increase of at least 30 beats/min or an increase to a rate higher than 120 beats/min within the first 10 minutes of standing, in the absence of orthostatic hypotension. 10 It is an autonomic disorder (dysautonomia) that can be associated with EDSs. 10 The symptoms of POTS include poor sleep quality, fatigue, dizziness, GI symptoms, esophageal hypomobility, gastroesophageal reflux disease, urinary issues, and skin manifestations.…”

“…10 It is an autonomic disorder (dysautonomia) that can be associated with EDSs. 10 The symptoms of POTS include poor sleep quality, fatigue, dizziness, GI symptoms, esophageal hypomobility, gastroesophageal reflux disease, urinary issues, and skin manifestations. 10 Previous studies have shown a high concurrence rate between hEDS and POTS.…”

“…10 The symptoms of POTS include poor sleep quality, fatigue, dizziness, GI symptoms, esophageal hypomobility, gastroesophageal reflux disease, urinary issues, and skin manifestations. 10 Previous studies have shown a high concurrence rate between hEDS and POTS. 11 Excessive catecholamine and histamine may be a mechanism for POTS in hEDS, although the exact cause is unknown.…”