title: Postural orthostatic tachycardia syndrome (POTS).
abstract: Postural orthostatic tachycardia syndrome (POTS) is a heterogeneous group of conditions characterised by autonomic dysfunction and an exaggerated sympathetic response to assuming an upright position. Up till recently, it was largely under-recognised as a clinical entity. There is now consensus about the definition of POTS as a greater than 30/min heart rate increase on standing from a supine position (greater than 40/min increase in 12-19-year-old patients) or an absolute heart rate of greater than 120/min within 10 min of standing from a supine position and in the absence of hypotension, arrhythmias, sympathomimetic drugs or other conditions that cause tachycardia. We present two cases of POTS, followed by a discussion of its pathogenesis, pathophysiology, epidemiology and management.
authors.affiliation: Department of General Medicine, NHS, Birmingham, West Midlands, UK.
authors.forename: Bharat
authors.initials: B
authors.lastname: Sidhu
authors.forename: Nonyelum
authors.initials: N
authors.lastname: Obiechina
authors.forename: Noman
authors.initials: N
authors.lastname: Rattu
authors.forename: Shanta
authors.initials: S
authors.lastname: Mitra
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000328:Adult; D001552:Benzazepines / Q000627:therapeutic use; D005260:Female; D005438:Fludrocortisone / Q000627:therapeutic use; D005440:Fluid Therapy; D006801:Humans; D000077550:Ivabradine; D008879:Midodrine / Q000627:therapeutic use; D054972:Postural Orthostatic Tachycardia Syndrome / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy; D013566:Sympathomimetics / Q000627:therapeutic use
chemical_list: D000319:Adrenergic beta-Antagonists; D001552:Benzazepines; D013566:Sympathomimetics; D000077550:Ivabradine; D008879:Midodrine; D005438:Fludrocortisone
references.citation: Br J Clin Pharmacol. 1979 Sep;8(3):253-60
references.pmid: 497092
references.citation: Int J Clin Pract. 2006 Feb;60(2):222-8
references.pmid: 16451297
references.citation: Indian Pacing Electrophysiol J. 2006 Apr 01;6(2):84-99
references.pmid: 16943900
references.citation: Neurology. 1993 Jan;43(1):132-7
references.pmid: 8423877
references.citation: Hypertension. 2005 Mar;45(3):391-8
references.pmid: 15699447
references.citation: Circulation. 2009 Sep 1;120(9):725-34
references.pmid: 19687359
references.citation: J Cardiovasc Electrophysiol. 2009 Mar;20(3):352-8
references.pmid: 19207771
references.citation: Circulation. 2008 May 27;117(21):2814-7
references.pmid: 18506020
references.citation: Europace. 2011 Mar;13(3):427-30
references.pmid: 21062792
references.citation: Clin Auton Res. 2000 Oct;10(5):279-84
references.pmid: 11198483
references.citation: Circ J. 2011;75(4):927-31
references.pmid: 21301135
references.citation: Mayo Clin Proc. 2007 Mar;82(3):308-13
references.pmid: 17352367
references.citation: J Geriatr Cardiol. 2012 Mar;9(1):61-7
references.pmid: 22783324
references.citation: Auton Neurosci. 2011 Apr 26;161(1-2):46-8
references.pmid: 21393070
references.citation: Clin Auton Res. 2000 Feb;10(1):29-33
references.pmid: 10750641
references.citation: Postgrad Med J. 2007 Jul;83(981):478-80
references.pmid: 17621618
references.citation: Circulation. 2005 May 31;111(21):2734-40
references.pmid: 15911704
references.citation: Am J Physiol Heart Circ Physiol. 2005 Sep;289(3):H1226-33
references.pmid: 15863453
references.citation: Clin Auton Res. 2000 Oct;10(5):293-9
references.pmid: 11198485
references.citation: Nat Rev Neurol. 2011 Dec 06;8(1):22-34
references.pmid: 22143364
references.citation: Pacing Clin Electrophysiol. 2005 Sep;28(9):975-9
references.pmid: 16176538