Postural orthostatic tachycardia syndrome: New concepts in pathophysiology and management

Grubb, Alex; Grubb, Blair P.

doi:10.1016/j.tcm.2021.10.007

Cited by 10 publications

(2 citation statements)

References 52 publications

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“…They further emphasize nonpharmacological treatments as a first-line treatment for all patients with POTS (Sheldon et al, 2015). Reviews of nonpharmacological treatments for POTS focus almost exclusively on lifestyle modifications (i.e., compression garments to improve circulation, aerobic conditioning to increase stroke volume and venous return, sodium and fluid intake to increase plasma volume), which have become standard interventions due to demonstrating improvements in symptomology, autonomic functioning, and orthostatic tolerance (i.e., the ability to remain upright without symptoms; Boris & Moak, 2022; Grubb & Grubb, 2022). Although research supports the efficacy of these interventions, little is known regarding other nonpharmacological treatment approaches that may benefit individuals with POTS and contribute to comprehensive care.…”

Section: Literature Searchmentioning

confidence: 99%

Nonpharmacological treatment of postural orthostatic tachycardia syndrome: Commentary and implications for psychologists.

Frye¹

2024

Clinical Practice in Pediatric Psychology

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Objective: Postural orthostatic tachycardia syndrome (POTS) is a type of autonomic dysfunction that limits engagement in functional behaviors and negatively impacts mood and quality of life (QoL). Nonpharmacological strategies such as lifestyle modification are recommended as part of treatment; however, there is little research or theory regarding other nonpharmacological therapies used in treatment. Given the paucity of literature examining other nonpharmacological therapies for POTS, current evidence for their application to POTS was reviewed. Methods: A topical review was conducted to identify research studies that used nonpharmacological interventions to treat individuals with POTS. Results: Of the 370 identified studies, 25 met inclusion criteria. Sixteen of the 25 studies examined lifestyle modifications for POTS and were not described in the review, given that lifestyle modifications are already well accepted and recommended in nonpharmacological treatment of POTS. The remaining studies were grouped into three categories: Tactile Interventions, Mind-Body Interventions, and Interdisciplinary Treatment Programs. Findings suggest a variety of nonpharmacological interventions have the potential of benefiting patients with POTS; however, the scarcity of studies and methodological concerns limit the interpretability of this research. Conclusions: An agenda for future research and implications for psychologists are provided. With the help of psychologists to advance applied research in effective nonpharmacological strategies for treatment, patients with POTS will have access to additional treatment options that address their biopsychosocial needs and hopefully positively impact QoL. Implications for Impact StatementIn addition to currently recommended lifestyle modifications, other nonpharmacological strategies may have the potential to benefit patients with postural orthostatic tachycardia syndrome (POTS). While the literature on these nonpharmacological interventions is limited, providers can build on initial findings to create treatment protocols or coordinate multicenter studies to examine different nonpharmacological interventions and provide additional options for patients with POTS to receive holistic care.

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Section: Literature Searchmentioning

confidence: 99%

Nonpharmacological treatment of postural orthostatic tachycardia syndrome: Commentary and implications for psychologists.

Frye¹

2024

Clinical Practice in Pediatric Psychology

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“…If POTS is present, AFTs can determine the specific form—primary or “partial dysautonomic” that is characterized by venous pooling and orthostatic hypotension, or “hyperadrenergic” that is characterized by orthostatic hypertension and tachycardia. 65 This differentiation can be critical in determining management, and may be difficult to discern without formal testing.…”

Section: Diagnostic Studiesmentioning

confidence: 99%

A Review of Neurological Symptoms in Long COVID and Clinical Management

Navis

2023

Semin Neurol

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Long COVID is a clinical diagnosis generally referring to the persistence or development of new symptoms, affecting multiple organ systems after SARS-CoV-2 COVID-19 infection. Long COVID is thought to affect ∼20% of people after infection, including all age ranges and severity of infection. Fatigue, postexertional malaise, and respiratory and cardiac symptoms are commonly described. Neurological symptoms such as cognitive changes, sensory disturbances, headaches, and dysautonomia are common as well. The underlying pathophysiology remains unclear but immune dysregulation, autoimmunity, persistent viral reservoirs, and microvascular dysfunction have been implicated. As there are no tests at this time to diagnose long COVID, work-up should be focused on assessing reversible or treatable causes of symptoms. Furthermore, no treatments for long COVID currently exist, and management remains focused on a multimodal approach and symptom management, with many people showing improvement in symptoms over time.

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Exploring quality of life in postural orthostatic tachycardia syndrome: A conceptual analysis

Frye,

Greenberg

2024

Autonomic Neuroscience

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Postural orthostatic tachycardia syndrome: New concepts in pathophysiology and management

Cited by 10 publications

References 52 publications

Nonpharmacological treatment of postural orthostatic tachycardia syndrome: Commentary and implications for psychologists.

Nonpharmacological treatment of postural orthostatic tachycardia syndrome: Commentary and implications for psychologists.

A Review of Neurological Symptoms in Long COVID and Clinical Management

Exploring quality of life in postural orthostatic tachycardia syndrome: A conceptual analysis

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