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AIMS Neuroscience

2021, Volume 8, Issue 1: 74-85. doi: 10.3934/Neuroscience.2021004
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Research article

Postural orthostatic tachycardia syndrome in patients of orthostatic intolerance symptoms: an ambispective study

  • Department of Neurology, Sri Aurobindo Medical College and Post Graduate Institute, Indore, M.P. India
  • Received: 03 October 2020 Accepted: 01 December 2020 Published: 08 December 2020

  • Background A Postural orthostatic tachycardia syndrome (POTS) is infrequently diagnosed in routine practice because of the variable range of symptoms that could be seen in cardiac rhythm disorders, vertigo, chronic fatigue syndrome and anxiety panic disorder. POTS is a chronic debilitating condition that affects day to day efficient working of an individual. We have planned a study to look for POTS in patients who are having orthostatic intolerance symptoms and underwent a head-up tilt table test (HUTT). Aim To study the prevalence of POTS in patients of orthostatic intolerance (OI) symptoms and to analyze symptomatology, its association with neurocardiogenic syncope (NCS), and its outcome. Methods We reviewed the medical records of 246 patients presented with symptoms of OI seen at our centre from January 2010 till March 2019. Out of them, 40 patients included, those qualifying the criteria for POTS on HUTT. Results The mean age of the cohort was 25.90 ± 10.33 years with a range of 15 to 55 years, and males comprised 52.5% (21/40) of total patients. The most frequent presenting orthostatic symptoms of POTS patients are loss of consciousness (77.5%), lightheadedness (75%), and palpitation (67.5%). A total of 18 patients (45%) had coexisting neurocardiogenic syncope. Conclusion POTS is a prevalent condition and have a significant impact on the quality of life, and the majority of patients may not present with OI symptoms during HUTT. We have to keep this possibility in young patients of transient loss of consciousness because it may coexist with NCS.

    Citation: Dinesh Chouksey, Pankaj Rathi, Ajoy Sodani, Rahul Jain, Hashash Singh Ishar. Postural orthostatic tachycardia syndrome in patients of orthostatic intolerance symptoms: an ambispective study[J]. AIMS Neuroscience, 2021, 8(1): 74-85. doi: 10.3934/Neuroscience.2021004

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  • Background A Postural orthostatic tachycardia syndrome (POTS) is infrequently diagnosed in routine practice because of the variable range of symptoms that could be seen in cardiac rhythm disorders, vertigo, chronic fatigue syndrome and anxiety panic disorder. POTS is a chronic debilitating condition that affects day to day efficient working of an individual. We have planned a study to look for POTS in patients who are having orthostatic intolerance symptoms and underwent a head-up tilt table test (HUTT). Aim To study the prevalence of POTS in patients of orthostatic intolerance (OI) symptoms and to analyze symptomatology, its association with neurocardiogenic syncope (NCS), and its outcome. Methods We reviewed the medical records of 246 patients presented with symptoms of OI seen at our centre from January 2010 till March 2019. Out of them, 40 patients included, those qualifying the criteria for POTS on HUTT. Results The mean age of the cohort was 25.90 ± 10.33 years with a range of 15 to 55 years, and males comprised 52.5% (21/40) of total patients. The most frequent presenting orthostatic symptoms of POTS patients are loss of consciousness (77.5%), lightheadedness (75%), and palpitation (67.5%). A total of 18 patients (45%) had coexisting neurocardiogenic syncope. Conclusion POTS is a prevalent condition and have a significant impact on the quality of life, and the majority of patients may not present with OI symptoms during HUTT. We have to keep this possibility in young patients of transient loss of consciousness because it may coexist with NCS.


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    Conflict of interest


    The authors declare no conflict of interest.

    [1] Kanjwal Y, Kosinski D, Grubb BP (2003) The postural orthostatic tachycardia syndrome: definitions, diagnosis, and management. Pacing Clin Electrophysiol 26: 1747-1757. doi: 10.1046/j.1460-9592.2003.t01-1-00262.x
    [2] Freeman R, Wieling W, Axelrod FB, et al. (2011) Consensus statement on the definition of orthostatic hypotension, neurally mediated syncope and the postural tachycardia syndrome. Clin Auton Res 21: 69-72. doi: 10.1007/s10286-011-0119-5
    [3] Stewart JM (2009) Postural tachycardia syndrome and reflex syncope: similarities and differences. J Pediatr 154: 481-485. doi: 10.1016/j.jpeds.2009.01.004
    [4] Thieben MJ, Sandroni P, Sletten DM, et al. (2007) Postural orthostatic tachycardia syndrome: the Mayo clinic experience. Mayo Clin Proc 82: 308-313. doi: 10.1016/S0025-6196(11)61027-6
    [5] Peltier AC, Garland E, Raj SR, et al. (2010) Distal sudomotor findings in postural tachycardia syndrome. Clin Auton Res 20: 93-99. doi: 10.1007/s10286-009-0045-y
    [6] Sandroni P, Opfer-Gehrking TL, McPhee BR, et al. (1999) Postural tachycardia syndrome: clinical features and follow-up study. Mayo Clin Proc 74: 1106-1110. doi: 10.4065/74.11.1106
    [7] Low PA, Sandroni P, Joyner M, et al. (2009) Postural tachycardia syndrome (POTS). J Cardiovasc Electrophysiol 20: 352-358. doi: 10.1111/j.1540-8167.2008.01407.x
    [8] Raj SR (2013) Postural tachycardia syndrome (POTS). Circulation 127: 2336-2342. doi: 10.1161/CIRCULATIONAHA.112.144501
    [9] Safavi-Naeini P, Razavi M (2020) Postural Orthostatic Tachycardia Syndrome. Tex Heart Inst J 47: 57-59. doi: 10.14503/THIJ-19-7060
    [10] Bryarly M, Phillips LT, Fu Q, et al. (2019) Postural Orthostatic Tachycardia Syndrome: JACC Focus Seminar. J Am Coll Cardiol 73: 1207-1228. doi: 10.1016/j.jacc.2018.11.059
    [11] Chen-Scarabelli C, Scarabelli TM (2004) Neurocardiogenic syncope. BMJ 329: 336-341. doi: 10.1136/bmj.329.7461.336
    [12] Raj SR (2006) The Postural Tachycardia Syndrome (POTS): pathophysiology, diagnosis & management. Indian Pacing Electrophysiol J 6: 84-99.
    [13] Chouksey D, Sodani A (2015) Extended head-up tilt table test (HUTT) in unexplained recurrent loss of consciousness;asingle-center prospective study. Int J Adv Res 3: 661-670.
    [14] Zaqqa M, Massumi A (2000) Neurally mediated syncope. Tex Heart Inst J 27: 268-272.
    [15] Carew S, Connor MO, Cooke J, et al. (2009) A review of postural orthostatic tachycardia syndrome. Europace 11: 18-25. doi: 10.1093/europace/eun324
    [16] Wells R, Spurrier AJ, Linz D, et al. (2018) Postural tachycardia syndrome: current perspectives. Vasc Health Risk Manag 14: 1-11. doi: 10.2147/VHRM.S127393
    [17] Grubb BP (2005) Neurocardiogenic syncope and related disorders of orthostatic intolerance. Circulation 111: 2997-3006. doi: 10.1161/CIRCULATIONAHA.104.482018
    [18] Kanjwal K, Sheikh M, Karabin B, et al. (2011) Neurocardiogenic syncope coexisting with postural orthostatic tachycardia syndrome in patients suffering from orthostatic intolerance: a combined form of autonomic dysfunction. Pacing Clin Electrophysiol 34: 549-554. doi: 10.1111/j.1540-8159.2010.02994.x
    [19] Bartoletti A, Alboni P, Ammirati F, et al. (2000) ‘The Italian Protocol’: a simplified head-up tilt testing potentiated with oral nitroglycerin to assess patients with unexplained syncope. Europace 2: 339-342. doi: 10.1053/eupc.2000.0125
    [20] Sheldon RS, Grubb BP, Olshansky B, et al. (2015) 2015 heart rhythm society expert consensus statement on the diagnosis and treatment of postural tachycardia syndrome, inappropriate sinus tachycardia, and vasovagal syncope. Heart Rhythm 12: e41-e63. doi: 10.1016/j.hrthm.2015.03.029
    [21] Jacob G, Costa F, Shannon JR, et al. (2000) The neuropathic postural tachycardia syndrome. N Engl J Med 343: 1008-1014. doi: 10.1056/NEJM200010053431404
    [22] Lee H, Low PA, Kim HA (2017) Patients with Orthostatic Intolerance: Relationship to Autonomic Function Tests results and Reproducibility of Symptoms on Tilt. Sci Rep 7: 5706. doi: 10.1038/s41598-017-05668-4
    [23] Thieben MJ, Sandroni P, Sletten DM, et al. (2007) Postural orthostatic tachycardia syndrome: the Mayo clinic experience. Mayo Clin Proc 82: 308-313. doi: 10.1016/S0025-6196(11)61027-6
    [24] Pandian JD, Dalton K, Henderson RD, et al. (2007) Postural orthostatic tachycardia syndrome: an underrecognized disorder. Intern Med J 37: 529-535. doi: 10.1111/j.1445-5994.2007.01356.x
    [25] Neeraj, Deolalikar S, Pannu A, et al. (2019) Clinical profile and cardiovascular autonomic function tests in patients with postural orthostatic tachycardia syndrome. CHRISMED J Health Res 6: 79-82. doi: 10.4103/cjhr.cjhr_81_18
    [26] Ives CT, Kimpinski K (2013) Higher postural heart rate increments on head-up tilt correlate with younger age but not orthostatic symptoms. J Appl Physiol (1985) 115: 525-528. doi: 10.1152/japplphysiol.00292.2013
    [27] Huh TE, Yeom JS, Kim YS, et al. (2013) Orthostatic symptoms does not always manifest during tilt-table test in pediatric postural orthostatic tachycardia syndrome patients. Korean J Pediatr 56: 32-36. doi: 10.3345/kjp.2013.56.1.32
    [28] Wieling W (1988) Standing, orthostatic stress and autonomic function. A textbook of clinical disorders of the autonomic nervous system Oxford: Oxford University Press, 308-320.
    [29] Ojha A, McNeeley K, Heller E, et al. (2010) Orthostatic syndromes differ in syncope frequency. Am J Med 123: 245-249. doi: 10.1016/j.amjmed.2009.09.018
    [30] Krediet CT, van Dijk N, Linzer M, et al. (2002) Management of vasovagal syncope: controlling or aborting faints by leg crossing and muscle tensing. Circulation 106: 1684-1689. doi: 10.1161/01.CIR.0000030939.12646.8F
    [31] Galbreath MM, Shibata S, VanGundy TB, et al. (2011) Effects of exercise training on arterial-cardiac baroreflex function in POTS. Clin Auton Res 21: 73-80. doi: 10.1007/s10286-010-0091-5
    [32] Alshekhlee A, Guerch M, Ridha F, et al. (2008) Postural tachycardia syndrome with asystole on head-up tilt. Clin Auton Res 18: 36-39. doi: 10.1007/s10286-007-0445-9
    [33] Kimpinski K, Figueroa JJ, Singer W, et al. (2012) A prospective, 1-yearfollow-up study of postural tachycardia syndrome. Mayo Clin Proc 87: 746-752. doi: 10.1016/j.mayocp.2012.02.020
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