A review of postural orthostatic tachycardia syndrome.
A 21-year-old female reports an 18-month history of light-headedness on standing. This is often associated with palpitations and a feeling of intense anxiety. She has had two black-outs in the past 12 months. She is not taking any regular medications. Her supine blood pressure was 126/84 mmHg with a heart rate of 76 bpm, and her upright blood pressure was 122/80 mmHg with a heart rate of 114 bpm. A full system examination was otherwise normal. She had a 12-lead electrocardiogram performed which was unremarkable. She was referred for head-up tilt testing. She was symptomatic during the test and lost consciousness at 16 min. Figure 1 summarizes her blood pressure and heart rate response to tilting. A diagnosis of postural orthostatic tachycardia syndrome with overlapping vasovagal syncope was made.
Carew
Sheila
S
Blood Pressure Unit, Mid Western Regional Hospital, Limerick, Ireland.
Connor
Margaret O
MO
Cooke
John
J
Conway
Richard
R
Sheehy
Christine
C
Costelloe
Aine
A
Lyons
Declan
D
D005260:Female; D006801:Humans; D054971:Orthostatic Intolerance / Q000175:diagnosis* / Q000628:therapy*; D054972:Postural Orthostatic Tachycardia Syndrome / Q000175:diagnosis* / Q000628:therapy*; D018667:Tilt-Table Test / Q000379:methods*; D055815:Young Adult