Postural Orthostatic Tachycardia Syndrome (POTS): A Diagnostic Dilemma

Kamal Soliman; Steve Sturman; Prabodh K Sarkar; Atef Michael

Disclosures

Br J Cardiol. 2010;17(1):36-39. 

In This Article

Abstract and Introduction

Abstract

Postural orthostatic tachycardia syndrome (POTS) is a condition that results from orthostatic intolerance. Patients, frequently young females, present with tachycardia, headache, palpitation, sweating, nausea and near syncope, on changing their posture from lying to standing. It is frequently misdiagnosed as panic attacks or anxiety neurosis. Tilt-table testing is diagnostic. Treatment depends on the type, whether primary or secondary, and there are non-pharmacological and pharmacological options.

Introduction

Over the last few years, attention has been focused on a relatively new subgroup of disorders referred to as the postural orthostatic tachycardia syndrome (POTS). This syndrome includes a heterogeneous group of disorders that share the same characteristics.[1] POTS is characterised by orthostatic symptoms and dramatic increase in heart rate on standing, but does not involve orthostatic hypotension. Tilt-table testing has become the 'gold standard' for diagnosing this disorder. In primary care, many patients with POTS may be misdiagnosed as anxiety neurosis, and potential therapeutic opportunities may be missed. In this article, we present and discuss a case with POTS.

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