Document Detail

Comparison of the postural tachycardia syndrome (POTS) with orthostatic hypotension due to autonomic failure.
MedLine Citation:
PMID:  7884158     Owner:  NLM     Status:  MEDLINE    
Postural tachycardia syndrome (POTS) is characterized by orthostatic dizziness, tremulousness, tachycardia and variable blood pressure changes. Since some POTS patients have a marked reduction in pulse pressure on standing, a major mechanism of their symptoms might be venous pooling. We therefore studied the cardiovascular response to head-up tilt, Valsalva maneuver and deep breathing in: control subjects (n = 11; F = 8; M = 3; 39.2 +/- 14.4 years); patients with orthostatic hypotension secondary to autonomic failure (n = 11; F = 9; M = 2; 61.7 +/- 13.0 years), and patients with POTS (n = 15); F = 13; M = 2; 32.3 +/- 10.6 years). Blood pressure was measured with a Finapres, and cardiac output, stroke volume, end-diastolic volume and thoracic impedance (TFI) were measured by thoracic electrical bioimpedance. During tilt (in contrast to patients with orthostatic hypotensiom), patients with POTS had excessive tachycardia (P < 0.001), a normal to excessive total peripheral resistance increase, and an exaggerated decrease in stroke volume (P < 0.001) and end-diastolic volume (P < 0.001). These findings suggest that sympathetic arteriolar function remains relatively intact but that sympathetic venomotor function is selectively impaired. These findings may have significant implications for the treatment of patients with POTS.
P A Low; T L Opfer-Gehrking; S C Textor; R Schondorf; G A Suarez; R D Fealey; M Camilleri
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Journal of the autonomic nervous system     Volume:  50     ISSN:  0165-1838     ISO Abbreviation:  J. Auton. Nerv. Syst.     Publication Date:  1994 Dec 
Date Detail:
Created Date:  1995-04-10     Completed Date:  1995-04-10     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  8003419     Medline TA:  J Auton Nerv Syst     Country:  NETHERLANDS    
Other Details:
Languages:  eng     Pagination:  181-8     Citation Subset:  IM; S    
Department of Neurology, Mayo Clinic, Rochester, MN 55905.
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MeSH Terms
Autonomic Nervous System Diseases / physiopathology*
Blood Pressure / physiology
Cardiac Output / physiology
Heart Rate / physiology
Hypotension, Orthostatic / physiopathology*
Middle Aged
Reflex / physiology
Tachycardia / physiopathology*
Valsalva Maneuver
Grant Support

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