Comparison of the postural tachycardia syndrome (POTS) with orthostatic hypotension due to autonomic failure

Phillip Anson Low, Tonette L. Opfer-Gehrking, Stephen C Textor, Ronald Schondorf, Guillermo A. Suarez, Robert D. Fealey, Michael Camilleri

Research output: Contribution to journalArticle

78 Citations (Scopus)

Abstract

Postural tachycardia syndrome (POTS) is characterized by orthostatic dizziness, tremulousness, tachycardia and variable blood pressure changes. Since some POTS patients have a marked reduction in pulse pressure on standing, a major mechanism of their symptoms might be venous pooling. We therefore studied the cardiovascular response to head-up tilt, Valsalva maneuver and deep breathing in: control subjects (n = 11; F = 8; M = 3; 39.2 ± 14.4 years); patients with orthostatic hypotension secondary to autonomic failure (n = 11; F = 9; M = 2; 61.7 ± 13.0 years), and patients with POTS (n = 15); F = 13; M = 2; 32.3 ± 10.6 years). Blood pressure was measured with a Finapres, and cardiac output, stroke volume, end-diastolic volume and thoracic impedance (TFI) were measured by thoracic electrical bioimpedance. During tilt (in contrast to patients with orthostatic hypotensiom), patients with POTS had excessive tachycardia (P < 0.001), a normal to excessive total peripheral resistance increase, and an exaggerated decrease in stroke volume (P < 0.001) and end-diastolic volume (P < 0.001). These findings suggest that sympathetic arteriolar function remains relatively intact but that sympathetic venomotor function is selectively impaired. These findings may have significant implications for the treatment of patients with POTS.

Original languageEnglish (US)
Pages (from-to)181-188
Number of pages8
JournalJournal of the Autonomic Nervous System
Volume50
Issue number2
DOIs
StatePublished - Dec 15 1994

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Postural Orthostatic Tachycardia Syndrome
Orthostatic Hypotension
Blood Pressure
Tachycardia
Stroke Volume
Thorax
Valsalva Maneuver
Dizziness
Electric Impedance
Cardiac Output
Vascular Resistance
Respiration
Head

Keywords

  • Autonomic failure
  • Finapres
  • Impedance
  • Venous pooling

ASJC Scopus subject areas

  • Physiology
  • Clinical Neurology
  • Neuroscience(all)

Cite this

Comparison of the postural tachycardia syndrome (POTS) with orthostatic hypotension due to autonomic failure. / Low, Phillip Anson; Opfer-Gehrking, Tonette L.; Textor, Stephen C; Schondorf, Ronald; Suarez, Guillermo A.; Fealey, Robert D.; Camilleri, Michael.

In: Journal of the Autonomic Nervous System, Vol. 50, No. 2, 15.12.1994, p. 181-188.

Research output: Contribution to journalArticle

Low, Phillip Anson ; Opfer-Gehrking, Tonette L. ; Textor, Stephen C ; Schondorf, Ronald ; Suarez, Guillermo A. ; Fealey, Robert D. ; Camilleri, Michael. / Comparison of the postural tachycardia syndrome (POTS) with orthostatic hypotension due to autonomic failure. In: Journal of the Autonomic Nervous System. 1994 ; Vol. 50, No. 2. pp. 181-188.
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