UMEM Educational Pearls

Category: Cardiology

Title: Postural Tachycardia Syndrome

Keywords: Postural Tachycardia Syndrome, POTS (PubMed Search)

Posted: 5/2/2013 by Semhar Tewelde, MD (Emailed: 5/5/2013) (Updated: 5/5/2013)
Click here to contact Semhar Tewelde, MD

  • Postural tachycardia syndrome (POTS) is defined as orthostatic intolerance w/ an increase in heart rate by 30 bpm (or HR>120 bpm) that occurs within 10 mins of standing or upright tilt
  • Orthostatic intolerance due to POTS will NOT cause orthostatic hypotension (defined as fall of >20/10 mm Hg on standing); instead patients may display no change, a small decline, or even a modest increase in blood pressure
  • Symptoms include: palpitations, fatigue, lightheadedness, exercise intolerance, nausea, diminished concentration, tremulousness, and syncope
  • POTS is a heterogeneous group of disorders with similar clinical manifestations  
  1. Primary POTS - partial dysautonomia form
  2. Secondary POTS - hyperadrenergic form
  • Tx varies according to the subtype/etiology of POTS and must be individualized
  • *Caveat inappropriate sinus tachycardia (IST) and POTS are two different diagnosis where significant overlap exists, however thebtachycardia in IST is NOT postural 

           

 

 

References

Grubb B. Postural Tachycardia Syndrome. Circulation 2008; 117:2814-2817