scholarly journals Postpartum Postural Orthostatic Tachycardia Syndrome in a Patient with the Joint Hypermobility Syndrome

2009 ◽  
Vol 2009 ◽  
pp. 1-3 ◽  
Author(s):  
Khalil Kanjwal ◽  
Beverly Karabin ◽  
Yousuf Kanjwal ◽  
Blair P. Grubb
Keyword(s):  
Clinical Presentation ◽  
Joint Hypermobility ◽  
Tilt Test ◽  
Postural Orthostatic Tachycardia Syndrome ◽  
Women Of Childbearing Age ◽  
Childbearing Age ◽  
Hypermobility Syndrome ◽  
Joint Hypermobility Syndrome ◽  
Head Up Tilt ◽  
Head Up Tilt Test

Postural orthostatic tachycardia syndrome (POTS) commonly affects women of childbearing age. We report on a 37-year-old woman who developed symptoms of recurrent syncope in the postpartum period. Her head up tilt test and clinical presentation was consistent with POTS.

scholarly journals Orthostatic Intolerance and Postural Orthostatic Tachycardia Syndrome in Joint Hypermobility Syndrome/Ehlers-Danlos Syndrome, Hypermobility Type: Neurovegetative Dysregulation or Autonomic Failure?

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Claudia Celletti ◽  
Filippo Camerota ◽  
Marco Castori ◽  
Federica Censi ◽  
Laura Gioffrè ◽  
...  
Keyword(s):  
Spectral Analysis ◽  
Baroreflex Sensitivity ◽  
Orthostatic Intolerance ◽  
Joint Hypermobility ◽  
Tilt Test ◽  
Postural Orthostatic Tachycardia Syndrome ◽  
Hypermobility Syndrome ◽  
Joint Hypermobility Syndrome ◽  
Ehlers Danlos Syndrome ◽  
Danlos Syndrome

Background. Joint hypermobility syndrome/Ehlers-Danlos syndrome, hypermobility type (JHS/EDS-HT), is a hereditary connective tissue disorder mainly characterized by generalized joint hypermobility, skin texture abnormalities, and visceral and vascular dysfunctions, also comprising symptoms of autonomic dysfunction. This study aims to further evaluate cardiovascular autonomic involvement in JHS/EDS-HT by a battery of functional tests.Methods. The response to cardiovascular reflex tests comprising deep breathing, Valsalva maneuver, 30/15 ratio, handgrip test, and head-up tilt test was studied in 35 JHS/EDS-HT adults. Heart rate and blood pressure variability was also investigated by spectral analysis in comparison to age and sex healthy matched group.Results. Valsalva ratio was normal in all patients, but 37.2% of them were not able to finish the test. At tilt, 48.6% patients showed postural orthostatic tachycardia, 31.4% orthostatic intolerance, 20% normal results. Only one patient had orthostatic hypotension. Spectral analysis showed significant higher baroreflex sensitivity values at rest compared to controls.Conclusions.This study confirms the abnormal cardiovascular autonomic profile in adults with JHS/EDS-HT and found the higher baroreflex sensitivity as a potential disease marker and clue for future research.

Treatment questions in POTS with hypertension and syncope

Open Medicine ◽  
2008 ◽  
Vol 3 (3) ◽  
pp. 361-364
Author(s):  
Malgorzata Lelonek ◽  
Jan Goch
Keyword(s):  
Rate Increase ◽  
Electrophysiological Study ◽  
Tilt Test ◽  
Postural Orthostatic Tachycardia Syndrome ◽  
Heart Rate Increase ◽  
Short Term ◽  
Total Head ◽  
Adrenergic Blocker ◽  
Head Up Tilt ◽  
Head Up Tilt Test

AbstractA 27-year old man experienced recurrent syncope with prodromal palpitations and resultant injury. The features of these episodes suggested a potentially neurally-mediated mechanism. Head-up tilt test revealed the postural orthostatic tachycardia syndrome (POTS). Within the first minutes of upright posture during the total head-up tilt testing, a heart rate increase of >30 beats/min and to a maximum of 150 beats/min was documented in the patient. At the end of passive tilting, the patient lost consciousness in the absence of hypotension while in sinus rhythm of 140 bpm. The 12-lead ECG and electrophysiological study showed no abnormalities. The patient received a beta-adrenergic blocker, a selective central imidazoline receptor agonist and psychiatric therapy, resulting in only a short-term improvement.

scholarly journals Orthostatic intolerance in adults with long COVID was not associated with postural orthostatic tachycardia syndrome

2021 ◽  
Author(s):  
Ann Monaghan ◽  
Glenn Jennings ◽  
Feng Xue ◽  
Lisa Byrne ◽  
Eoin Duggan ◽  
...  
Keyword(s):  
Daily Living ◽  
Orthostatic Intolerance ◽  
Cross Sectional Study ◽  
Tilt Test ◽  
Postural Orthostatic Tachycardia Syndrome ◽  
Sectional Study ◽  
Cross Sectional ◽  
Minute Post ◽  
Head Up Tilt ◽  
Head Up Tilt Test

In this observational cross-sectional study, we investigated predictors of orthostatic intolerance (OI) in adults with long COVID. Participants underwent a 3-minute active stand (AS) with Finapres NOVA, followed by a 10-minute unmedicated 70-degree head-up tilt test. 85 participants were included (mean age 46 years, range 25-78; 74% women), of which 56 (66%) reported OI during AS (OIAS). OIAS seemed associated with female sex, more fatigue and depressive symptoms, and greater inability to perform activities of daily living (ADL), as well as a higher heart rate (HR) at the lowest systolic blood pressure (SBP) point before the 1st minute post-stand (mean HRnadir: 88 vs 75 bpm, P=0.004). In a regression model also including age, sex, fatigue, depression, ADL inability, and peak HR after the nadir SBP, HRnadir was the only OIAS predictor (OR=1.09, 95% CI: 1.01-1.18, P=0.027). 22 participants had initial (iOH) and 5 classical (cOH) orthostatic hypotension, but neither correlated with OIAS. 71 participants proceeded to tilt, of which 28 had OI during tilt (OItilt). Of the 53 who had a 10-minute tilt, 7 (13%) fulfilled hemodynamic postural orthostatic tachycardia syndrome (POTS) criteria, but 6 did not report OItilt. OIAS was associated with a higher initial HR on AS, which after 1 minute equalized with the non-OIAS group. Despite these initial orthostatic HR differences, POTS was infrequent and largely asymptomatic. ClinicalTrials.gov Identifier: NCT05027724 (retrospectively registered on August 30, 2021).

Tilt angles and positive response of head-up tilt test in children with orthostatic intolerance

2013 ◽  
Vol 25 (1) ◽  
pp. 76-80 ◽  
Author(s):  
Jing Lin ◽  
Yuli Wang ◽  
Todd Ochs ◽  
Chaoshu Tang ◽  
Junbao Du ◽  
...  
Keyword(s):  
Tilt Angle ◽  
Positive Response ◽  
Orthostatic Intolerance ◽  
Vasovagal Syncope ◽  
Tilt Test ◽  
Postural Orthostatic Tachycardia Syndrome ◽  
Appearance Time ◽  
Significant Difference ◽  
Head Up Tilt ◽  
Head Up Tilt Test

AbstractThis study aimed at examining three tilt angle-based positive responses and the time to positive response in a head-up tilt test for children with orthostatic intolerance, and the psychological fear experienced at the three angles during head-up tilt test. A total of 174 children, including 76 boys and 98 girls, aged from 4 to 18 years old (mean 11.3±2.8 years old), with unexplained syncope, were randomly divided into three groups, to undergo head-up tilt test at the angles of 60°, 70° and 80°, respectively. The diagnostic rates and times were analysed, and Wong–Baker face pain rating scale was used to access the children’s psychological fear. There were no significant differences in diagnostic rates of postural orthostatic tachycardia syndrome and vasovagal syncope at different tilt angles during the head-up tilt test (p>0.05). There was a significant difference, however, in the psychological fear at different tilt angles utilising the Kruskal–Wallis test (χ2=36.398, p<0.01). It was mildest at tilt angle 60° utilising the Kolmogorov–Smirnov test (p<0.01). A positive rank correlation was found between the psychological fear and the degree of tilt angle (rs=0.445, p<0.01). Positive response appearance time was 15.1±14.0 minutes at 60° for vasovagal syncope children. There was no significant difference in the time to positive response, at different tilt angles during the head-up tilt test for vasovagal syncope or for postural orthostatic tachycardia syndrome. Hence, it is suggested that a tilt angle of 60° and head-up tilt test time of 45 minutes should be suitable for children with vasovagal syncope.

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