Postural Orthostatic Tachycardia Syndrome

Excerpt

Postural orthostatic tachycardia syndrome (POTS) is a common form of autonomic dysregulation characterized as an excessive tachycardia upon standing in the presence of orthostatic intolerance. Current adult diagnostic criterion requires a heart rate increase of greater than or equal to 30 bpm within the initial 10 minutes of standing or head-up tilt (HUT) in the absence of orthostatic hypotension. POTS predominantly affects premenopausal females (5 to 1) between 15 and 50 years of age, manifesting with symptoms of fatigue, headache, palpitations, sleep disturbance, nausea, bloating, among others. A multitude of pathophysiologic mechanisms including but not limited to disproportionate sympathoexcitation, volume depletion, autoimmune dysfunction, cardiac and physical deconditioning point to a heterogeneously complex etiology. Most significantly, the debilitating nature of POTS predisposes patients to a high degree of functional impairment and decreased quality of life, emphasizing the need for further investigation into the understanding and management of this increasingly prevalent clinical syndrome.