Managing Fatigue in the Syncope Unit

Julia L. Newton


Europace. 2012;14(12):1696-1699. 

In This Article

Positional Orthostatic Tachycardia Syndrome

Positional orthostatic tachycardia syndrome (POTS) has been increasingly recognized in syncope units over the last decade.[24] Historically it has been considered a relatively rare autonomic disorder, it is becoming more frequently diagnosed as technology allows for continuous haemodynamic testing while performing standardized orthostasis. Patients with POTS frequently describe fatigue symptoms.[8,24,25] Recent studies have confirmed that when subjected to a comprehensive autonomic assessment 27% of patients with CFS as a diagnosis attending a local CFS clinic have a diagnosis of POTS on formal autonomic assessment.[8] In addition, patients with POTS, i.e. those presenting significant tachycardia on assuming the upright position, on direct questioning will frequently describe fatigue symptoms.[24] As a result, patients with this condition can present to the syncope unit either directly with symptoms focussed upon the tachycardia associated with POTS and therefore require additional management of their fatigue, or attend a CFS service where tachycardia is noticed.