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2015 ; 15
(9
): 60
Nephropedia Template TP
Curr Neurol Neurosci Rep
2015[Sep]; 15
(9
): 60
PMID26198889
show ga
Postural tachycardia syndrome (POTS) is a form of chronic orthostatic intolerance
for which the hallmark physiological trait is an excessive increase in heart rate
with assumption of upright posture. The orthostatic tachycardia occurs in the
absence of orthostatic hypotension and is associated with a >6-month history of
symptoms that are relieved by recumbence. The heart rate abnormality and
orthostatic symptoms should not be caused by medications that impair autonomic
regulation or by debilitating disorders that can cause tachycardia. POTS is a
"final common pathway" for a number of overlapping pathophysiologies, including
an autonomic neuropathy in the lower body, hypovolemia, elevated sympathetic
tone, mast cell activation, deconditioning, and autoantibodies. Not only may
patients be affected by more than one of these pathophysiologies but also the
phenotype of POTS has similarities to a number of other disorders, e.g., chronic
fatigue syndrome, Ehlers-Danlos syndrome, vasovagal syncope, and inappropriate
sinus tachycardia. POTS can be treated with a combination of non-pharmacological
approaches, a structured exercise training program, and often some
pharmacological support.