The Postural Orthostatic Tachycardia Syndrome: A Potentially Treatable Cause of Chronic Fatigue, Exercise Intolerance, and Cognitive Impairment in Adolescents
Article first published online: 28 JUN 2006
Pacing and Clinical Electrophysiology
Volume 23, Issue 3, pages 344–351, March 2000
How to Cite
KARAS, B., GRUBB, B. P., BOEHM, K. and KIP, K. (2000), The Postural Orthostatic Tachycardia Syndrome: A Potentially Treatable Cause of Chronic Fatigue, Exercise Intolerance, and Cognitive Impairment in Adolescents. Pacing and Clinical Electrophysiology, 23: 344–351. doi: 10.1111/j.1540-8159.2000.tb06760.x
- Issue published online: 28 JUN 2006
- Article first published online: 28 JUN 2006
- Received April 20, 1999; revised June 22, 1999; accepted August 7, 1999.
- autonomic dysfunction;
Head upright tilt table testing has become an accepted method to measure an individual's predisposition to autonomically mediated periods of hypotension and bradycardia severe enough to cause frank syncope. At the same time it has become increasingly apparent that less profound falls in blood pressure, while not sufficient to result in loss of consciousness, may cause symptoms such as near syncope, vertigo, and dizziness. We describe a subgroup of adolescents that have a mild form of autonomic dysfunction that exhibit disabling symptoms such as postural tachycardia and palpitations, extreme fatigue, lightheadedness, exercise intolerance, and cognitive impairment. During baseline tilt table testing at a 70° angle, these patients demonstrated a heart rate increase of ≥30 beats/min (or a maximum heart rate of ≥120 beats/min) within the first 10 minutes upright (not associated with profound hypotension), which reproduced their clinical symptom complex. Similar observations have been made in the adult population and has been termed the postural orthostatic tachycardia syndrome (POTS). We report that POTS may also occur in adolescents and represents a mild, potentially treatable form of autonomic dysfunction that can be readily identified during head upright tilt table testing.