scholarly journals Demographic and clinical features of pediatric patients with orthostatic intolerance and an abnormal head-up tilt table test; A retrospective descriptive study

2020 ◽  
Vol 61 (1) ◽  
pp. 68-74
Author(s):  
Anand Gourishankar ◽  
Mathew D. Belton ◽  
S. Shahrukh Hashmi ◽  
Ian J. Butler ◽  
Jeremy E. Lankford ◽  
...  
Keyword(s):  
Clinical Features ◽  
Pediatric Patients ◽  
Orthostatic Intolerance ◽  
Descriptive Study ◽  
Tilt Table Test ◽  
Tilt Table ◽  
Abnormal Head ◽  
Head Up Tilt

scholarly journals Postural orthostatic tachycardia syndrome in primary care: diagnosis, treatment and a case of African-American man presenting with POTS

2019 ◽  
Vol 12 (9) ◽  
pp. e229824
Author(s):  
Andrew T Del Pozzi ◽  
Michael Enechukwu ◽  
Svetlana Blitshteyn
Keyword(s):  
Heart Rate ◽  
Differential Diagnosis ◽  
African American ◽  
Clinical Features ◽  
Orthostatic Intolerance ◽  
Treatment Options ◽  
Postural Orthostatic Tachycardia Syndrome ◽  
Tilt Table Test ◽  
Tilt Table ◽  
Caucasian Women

Postural orthostatic tachycardia syndrome (POTS) is a heterogeneous autonomic disorder characterised by orthostatic intolerance and a rise in heart rate by at least 30 bpm or an absolute heart rate value of at least 120 bpm within 10 min of standing or during a tilt table test. Overwhelmingly, POTS affects young Caucasian women, which can lead physicians to miss the diagnosis in men or non-white patients. We describe a case of 29-year-old African-American man who developed lightheadedness, generalised weakness, tachycardia and palpitations and was subsequently diagnosed with POTS. We review its clinical features, differential diagnosis, pathophysiology and treatment options. We also emphasise that POTS should be considered as a differential diagnosis in any patient presenting with typical clinical features, who may not be in the usual demographics of the disorder.

scholarly journals Intravenous Cyclophosphamide Treatment for Systemic Lupus Erythematosus with Severe Autonomic Disorders Confirmed by Head-Up Tilt Table Test: A Case Series

2021 ◽  
Author(s):  
Masataka Umeda ◽  
Hiroaki Kawano ◽  
Yushiro Endo ◽  
Ayuko Takatani ◽  
Tomohiro Koga ◽  
...  
Keyword(s):  
Lupus Erythematosus ◽  
Orthostatic Intolerance ◽  
Therapeutic Option ◽  
Case Series ◽  
Therapeutic Effects ◽  
Tilt Table Test ◽  
Tilt Table ◽  
Autonomic Disorders ◽  
Cyclophosphamide Treatment ◽  
Head Up Tilt

Abstract Autonomic disorders are common in patients with SLE, but the therapeutic strategy and methods for evaluating the effects of therapy have not been established. We describe the three cases of SLE patients who developed severe autonomic disorders as demonstrated by the head-up tilt table test (HUT). All three patients were treated by intensive immunosuppressive treatments including cyclophosphamide (IVCY); their HUT results all became negative. Our cases suggest that IVCY treatment can be a good therapeutic option for severe autonomic disorders in SLE patients. The HUT is a useful objective method for the diagnosis of and the evaluation of longitudinal therapeutic effects on autonomic disorders in SLE patients with orthostatic intolerance.

A clinical manifestation-based prediction of haemodynamic patterns of orthostatic intolerance in children: a multi-centre study

2013 ◽  
Vol 24 (4) ◽  
pp. 649-653 ◽  
Author(s):  
Li Chen ◽  
Xueying Li ◽  
Ochs Todd ◽  
Cheng Wang ◽  
Hongfang Jin ◽  
...  
Keyword(s):  
Clinical Study ◽  
Diagnostic Accuracy ◽  
Clinical Manifestation ◽  
Orthostatic Intolerance ◽  
Vasovagal Syncope ◽  
Postural Orthostatic Tachycardia Syndrome ◽  
Tilt Table Test ◽  
Tilt Table ◽  
Multi Centre Study ◽  
Head Up Tilt

AbstractObjective: At present, the haemodynamic diagnosis of orthostatic intolerance is based mainly on the head-up tilt table test, which is sometimes risky for patients. Thus, it is important to find objective and safe methods to differentiate haemodynamic patterns of orthostatic intolerance cases. Methods: In all, 629 children with orthostatic intolerance, either vasovagal syncope or postural orthostatic tachycardia syndrome, were included in the multi-centre clinical study. We analysed the association between the clinical manifestation and haemodynamic patterns of the patients. Results: Syncope after motion with a prodrome of chest distress or palpitations and the concomitant symptom(s) after a syncopal attack, with debilitation, dizziness or headache, were the most important variables in predicting the diagnosis of vasovagal syncope. The overall diagnostic accuracy was 71.5%. Conclusion: Complaint of syncope after motion with prodromal chest distress or palpitation and the concomitant symptom after a syncopal attack, with subsequent debilitation, dizziness or headache, were the most important variables in the diagnosis of vasovagal syncope in children with orthostatic intolerance.

scholarly journals Correlation of head-up tilt table test time interval with risk of recurrent syncope

2015 ◽  
Vol 67 ◽  
pp. S77
Author(s):  
R.K. Gokhroo ◽  
Kumari Priti ◽  
A. Avinash ◽  
Bhanwar Lal Ranwa ◽  
Kamal Kishor ◽  
...  
Keyword(s):  
Test Time ◽  
Time Interval ◽  
Tilt Table Test ◽  
Tilt Table ◽  
Head Up Tilt

Repolarization disparity as a predictor of response to Head Up Tilt‐table Test in pediatric syncope

2021 ◽  
Author(s):  
Mohammad Reza Khalilian ◽  
Abdolrahim Ghasemi ◽  
Narges Khazaei ◽  
Sara Khoshkhou ◽  
Elham Mahmoudi
Keyword(s):  
Tilt Table Test ◽  
Tilt Table ◽  
Head Up Tilt

scholarly journals The Differences in the Diagnostic Profile in Children with Vasovagal Syncope between the Result of Head-Up Tilt Table Test

2020 ◽  
Vol 17 (12) ◽  
pp. 4524
Author(s):  
Ewelina Kolarczyk ◽  
Lesław Szydłowski ◽  
Agnieszka Skierska ◽  
Grażyna Markiewicz-Łoskot
Keyword(s):  
Medical Records ◽  
Vasovagal Syncope ◽  
Speech Disorders ◽  
Tilt Table Test ◽  
Tilt Table ◽  
Prodromal Symptoms ◽  
Close Relationship ◽  
Head Up Tilt ◽  
Diagnostic Profile ◽  
Positive Results

(1) Background: The features characterizing vasovagal syncope (VVS) are an important factor in the correct evaluation of diagnostic risk stratification in children and adolescents. The aim of the study was to determine the value of identifying the clinical characteristics in children with VVS. (2) Methods: We made a retrospective analysis of the medical records of 109 children with diagnosed VVS. We investigated the specific characteristics of syncope in children with VVS including the positive VVS (+) and negative VVS (−) result of the Head-Up Tilt Table Test (HUTT). (3) Results: We did not observe significant differences in the prodromal symptoms of VVS with HUTT response. In addition to typical prodromal symptoms, no difference in statistically reported palpitations (35/109 or 32.1%) and chest discomfort (27/109 or 27.7%) were recorded. Fear–pain–stress emotions as circumstances of syncope were more often reported by children with a negative HUTT (p = 0.02). Cramps–contractures (p = 0.016) and speech disorders (p = 0.038) were significantly higher in the group with negative HUTT. (4) Conclusions: There is a close relationship in the diagnostic profile between the negative and positive results of head-up tilt table test in children with vasovagal syncope.

scholarly journals Relationship between sarcopenia and orthostatic hypotension

2020 ◽  
Vol 49 (6) ◽  
pp. 959-965 ◽  
Author(s):  
Pinar Soysal ◽  
Suleyman Emre Kocyigit ◽  
Ozge Dokuzlar ◽  
Esra Ates Bulut ◽  
Lee Smith ◽  
...  
Keyword(s):  
Orthostatic Hypotension ◽  
Healthcare Practitioner ◽  
Tilt Table Test ◽  
Older Patient ◽  
Tilt Table ◽  
European Consensus ◽  
Close Relationship ◽  
Head Up Tilt ◽  
The Mean ◽  
The Relationship

Abstract Background The relationship between sarcopenia and orthostatic hypotension (OH) is unclear. Objectives The aim of the present study was to investigate associations between sarcopenia/sarcopenia severity and OH. Design A total of 511 patients attending a geriatric outpatient clinic were included. OH was defined as a decrease in systolic and/or diastolic blood pressure of ≥ 20 mmHg and/or ≥ 10 mmHg, respectively, when one transitions from the supine to an upright position. OH was measured by the Head-up Tilt Table test at 1, 3 and 5 min (OH1, OH3 and OH5, respectively). Sarcopenia and its severity were defined according to the revised European consensus on definition and diagnosis. Results The mean age of the sample was 75.40 ± 7.35 years, and 69.9% were female. The prevalence of probable sarcopenia, sarcopenia and severe sarcopenia was 42.2%, 6.06% and 11.1%, respectively. After adjustment for all covariates, systolic OH1, OH1 and systolic OH5 were statistically significantly different between severe sarcopenia and the robust group (odds ratio [OR]: 3.26, confidence interval [CI] 0.98–10.84; P = 0.05 for systolic OH1; OR 4.31, CI 1.31–14.15; P = 0.016 for OH1; OR 4.09, CI 1.01–16.55; P = 0.048 for systolic OH5). Only systolic OH1 was statistically different between the sarcopenia and severe sarcopenia groups (OR 2.64, CI 1.87–8.73; P = 0.012). OH1 and OH5 were statistically significant different between severe sarcopenia and probable sarcopenia groups (P < 0.05); there was no relationship between the robust group and probable sarcopenia (P > 0.05). Conclusions There is a close relationship between sarcopenia and severe sarcopenia and OH in older adults. Therefore, when a healthcare practitioner is evaluating an older patient with sarcopenia, OH should also be evaluated, and vice versa.

scholarly journals Prolongation of Electrocardiographic T Wave Parameters Recorded during the Head-Up Tilt Table Test as Independent Markers of Syncope Severity in Children

2020 ◽  
Vol 17 (18) ◽  
pp. 6441
Author(s):  
Grażyna Markiewicz-Łoskot ◽  
Ewelina Kolarczyk ◽  
Bogusław Mazurek ◽  
Marianna Łoskot ◽  
Lesław Szydłowski
Keyword(s):  
Vasovagal Syncope ◽  
The Other ◽  
Control Group ◽  
Tilt Table Test ◽  
Tilt Table ◽  
T Wave ◽  
Good Discriminator ◽  
Wave Morphology ◽  
Head Up Tilt ◽  
T Waves

The head-up tilt table test (HUTT) with the upright phase is used to help determine an imbalance of the sympathetic nervous system that is related to abnormal electrocardiographic repolarization in children with vasovagal syncope (VVS) and also in patients with the long QT syndrome (LQTS). The study attempted to evaluate T wave morphology and QT and TpTe (Tpeak–Tend) intervals recorded in ECG during the HUTT for a more accurate diagnosis of children with VVS. The group investigated 70 children with a negative HUTT result: 40 patients with VVS and 30 healthy volunteers without syncope. The RR interval as well as TpTe, and QTc intervals were measured in lead V5 of electrocardiogram (ECG) on admission to the hospital and during three phases of the HUTT. In syncopal children, which included 23 children with bifid or flat T waves and 17 patients with normal T waves in the upright phase, the QTc and TpTe were longer (p < 0.001) compared to the other test phases and longer (p < 0.001) than in the control group, respectively, with the risk of arrhythmias. Only in the control group, the TpTe was shorter (p < 0.001) in the upright phase than in the other tilt phases. The TpTe in the upright phase (>70 ms) was a good discriminator, and was better than the QTc (>427 ms). Prolongation of electrocardiographic TpTe and QT intervals, in addition to the (abnormal T wave morphology recorded during the HUTT, are helpful for identifying VVS children more predisposed to ventricular arrhythmias with a latent risk of LQTS. Further studies are required to assess the value of these repolarization parameters in clinical practice.

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