title: Confounders of vasovagal syncope: postural tachycardia syndrome.
abstract: Most patients who present to a cardiologist with syncope have vasovagal (reflex) syncope. A busy syncope practice often also sees patients with postural tachycardia syndrome, often presenting with severe recurrent presyncope. Recognition of this syncope confounder might be difficult without adequate knowledge of their presentation, and this can adversely affect optimal management. Postural tachycardia syndrome can often be differentiated from vasovagal syncope by its hemodynamic pattern during tilt table test and differing clinical characteristics. This article reviews the presentation of postural tachycardia syndrome and its putative pathophysiology and presents an approach to nonpharmacologic and pharmacologic management.
authors.affiliation: Division of Clinical Pharmacology, Department of Medicine, Autonomic Dysfunction Center, Vanderbilt University School of Medicine, AA3228 Medical Center North, 1161 21st Avenue South, Nashville, TN 37232-2195, USA.
authors.forename: Victor C
authors.initials: VC
authors.lastname: Nwazue
authors.forename: Satish R
authors.initials: SR
authors.lastname: Raj
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D004452:Echocardiography; D004562:Electrocardiography; D005080:Exercise Test / Q000379:methods; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D008875:Middle Aged; D054972:Postural Orthostatic Tachycardia Syndrome / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D019462:Syncope, Vasovagal / Q000209:etiology* / Q000503:physiopathology; D018667:Tilt-Table Test