Postural tachycardia in children and adolescents: What is abnormal?

Wolfgang Singer, David M. Sletten, Tonette L. Opfer-Gehrking, Chad K. Brands, Philip R. Fischer, Phillip Anson Low

Research output: Contribution to journalArticle

109 Citations (Scopus)

Abstract

Objectives: To evaluate whether the use of adult heart rate (HR) criteria is appropriate for diagnosing orthostatic intolerance (OI) and postural tachycardia syndrome (POTS) in children and adolescents, and to establish normative data and diagnostic criteria for pediatric OI and POTS. Study design: A total of 106 normal controls aged 8-19 years (mean age, 14.5 ± 3.3 years) underwent standardized autonomic testing, including 5 minutes of 70-degree head-up tilt. The orthostatic HR increment and absolute orthostatic HR were assessed and retrospectively compared with values in 654 pediatric patients of similar age (mean age, 15.5 ± 2.3 years) who were referred to our Clinical Autonomic Laboratory with symptoms of OI. Results: The HR increment was mildly higher in patients referred for OI/POTS, but there was considerable overlap between the patient and control groups. Some 42% of the normal controls had an HR increment of ≥30 beats per minute. The 95th percentile for the orthostatic HR increment in the normal controls was 42.9 beats per minute. There was a greater and more consistent difference in absolute orthostatic HR between the 2 groups, although there was still considerable overlap. Conclusion: The diagnostic criteria for OI and POTS in adults are unsuitable for children and adolescents. Based on our normative data, we propose new criteria for the diagnosis of OI and POTS in children and adolescents.

Original languageEnglish (US)
Pages (from-to)222-226
Number of pages5
JournalJournal of Pediatrics
Volume160
Issue number2
DOIs
StatePublished - Feb 2012

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Orthostatic Intolerance
Postural Orthostatic Tachycardia Syndrome
Tachycardia
Heart Rate
Pediatrics
Head
Control Groups

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Postural tachycardia in children and adolescents : What is abnormal? / Singer, Wolfgang; Sletten, David M.; Opfer-Gehrking, Tonette L.; Brands, Chad K.; Fischer, Philip R.; Low, Phillip Anson.

In: Journal of Pediatrics, Vol. 160, No. 2, 02.2012, p. 222-226.

Research output: Contribution to journalArticle

Singer, W, Sletten, DM, Opfer-Gehrking, TL, Brands, CK, Fischer, PR & Low, PA 2012, 'Postural tachycardia in children and adolescents: What is abnormal?', Journal of Pediatrics, vol. 160, no. 2, pp. 222-226. https://doi.org/10.1016/j.jpeds.2011.08.054
Singer, Wolfgang ; Sletten, David M. ; Opfer-Gehrking, Tonette L. ; Brands, Chad K. ; Fischer, Philip R. ; Low, Phillip Anson. / Postural tachycardia in children and adolescents : What is abnormal?. In: Journal of Pediatrics. 2012 ; Vol. 160, No. 2. pp. 222-226.
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