title: Postural orthostatic tachycardia syndrome: diagnosis and treatment.
abstract: BACKGROUND
  Postural orthostatic tachycardia syndrome (POTS) is an autonomic disorder characterized by an exaggerated increase in heart rate that occurs during standing, without orthostatic hypotension. Women are most frequently affected, and may present with palpitations, chest discomfort, shortness of breath, weakness, exercise intolerance, lightheadedness, presyncope, and syncope.
  
  
  METHODS
  We present three cases of POTS in otherwise healthy women, and discuss the clinical management of different types of this orthostatic intolerance.
  
  
  CONCLUSIONS
  The diagnosis was established with a tilt-table test in 1 patient who became symptom-free with β-blockade and nonpharmacologic treatment, including fluid therapy, liberal sodium intake, support hose, and a reconditioning exercise program. The other 2 were diagnosed through a standing test, serum norepinephrine levels, and red-cell volumes. One patient had neuropathic POTS and partially responded to b-blockade and nonpharmacotherapy. The other patient had hyperadrenergic POTS and responded well to nonpharmacotherapy, a dualacting b-blocker, and a vasoconstrictor agent. Postural orthostatic tachycardia syndrome is not an uncommon clinical entity and making a correct diagnosis is crucial in providing appropriate treatment to restore patients' functional capability and quality of life.
authors.affiliation: School of Nursing, St. Louis University, St. Louis, Missouri 63104, USA. jthanava@slu.edu
authors.forename: Joanne L
authors.initials: JL
authors.lastname: Thanavaro
authors.forename: Kristin L
authors.initials: KL
authors.lastname: Thanavaro
mesh_terms: D000293:Adolescent; D000328:Adult; D002637:Chest Pain; D004417:Dyspnea; D017079:Exercise Tolerance; D005260:Female; D005440:Fluid Therapy; D006339:Heart Rate; D006801:Humans; D018908:Muscle Weakness; D054972:Postural Orthostatic Tachycardia Syndrome / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology / Q000628:therapy; D011379:Prognosis; D012307:Risk Factors; D013575:Syncope; D018667:Tilt-Table Test; D055815:Young Adult