[Postural orthostatic tachycardia syndrome (POTS): etiology, diagnosis and therapy].
BACKGROUND
Since the renaissance of tilt table testing in clinical cardiology some 15 years ago, the syndromes of autonomic dysfunction with orthostatic intolerance underwent improved differentiation and classification. In the present review a variant of autonomic dysfunction with orthostatic intolerance--POTS (postural orthostatic tachycardia syndrome)--will be discussed.


METHODS
The affected patients present with orthostatic intolerance, postural tachycardia, exercise intolerance, fatigue, dizziness and in some cases with other dysautonomic symptoms such as gastrointestinal or sudomotor dysfunction. Together with the clinical history, tilt table testing is the cornerstone of diagnostic evaluation by which the syndrome can be distinguished from typical neurocardiogenic disorders. POTS is characterized by different subtypes; accordingly, therapy for relief of symptoms is variable and includes beta blockers for patients with the hyperadrenergic type and alphamimetics for those with partial dysautonomia.


CONCLUSIONS
Although it is now possible to differ POTS from other forms of autonomic dysfunction, further research is warranted to clarify the pathophysiology of this syndrome and its subtypes and to improve therapeutic interventions.
Grubb
B P
BP
Department of Medicine, Medical College of Ohio, Richard D. Ruppert Health Center, Toledo, USA. bgrubb@mco.edu
Klingenheben
T
T
D018663:Adrenergic Agents / Q000627:therapeutic use*; D000316:Adrenergic alpha-Agonists / Q000627:therapeutic use; D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D001794:Blood Pressure; D003937:Diagnosis, Differential; D006339:Heart Rate; D006801:Humans; D007024:Hypotension, Orthostatic / Q000150:complications* / Q000175:diagnosis* / Q000188:drug therapy; D011187:Posture; D019462:Syncope, Vasovagal / Q000175:diagnosis; D013577:Syndrome; D013610:Tachycardia / Q000175:diagnosis* / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D018667:Tilt-Table Test
D018663:Adrenergic Agents; D000316:Adrenergic alpha-Agonists; D000319:Adrenergic beta-Antagonists