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         Postural Orthostatic Tachycardia Syndrome:     more detail
  1. Postural Orthostatic Tachycardia Syndrome: Dysautonomia, Orthostatic Intolerance, Supine Position,Tachycardia, Cerebral Blood Flow, Orthostatic Hypotension

81. 1
3) Chronic orthostatic Intolerance and the postural tachycardia syndrome CirculatoryFindings in POTS and CFS. Variants of POTS are shown along with a
http://www.nymc.edu/fhp/centers/syncope/POTS and COI.htm
POTS and Chronic Orthostatic Intolerance H ome NIH Studies:
  • CFS ... Search 3) Chronic Orthostatic Intolerance and the Postural Tachycardia Syndrome [Circulatory Findings in POTS and CFS] Variants of POTS a re shown along with a normal healthy control response to upright tilt. Classical POTS is shown with a rapid rise in heart rate and little fall in blood pressure. The study was terminated for intractable patient symptoms Patients with the syndrome display an unusual amount of pooling in the lower extremities often associated with acrocyanosis. It is likely that there are many physiologic mechanisms for POTS. The literature contains a number of potential explanations for abnormal venous pooling and fluid collection in POTS including impaired innervation of the veins or in their response to sympathetic stimulation. One such explanation favors an autonomic neuropathy that predominantly affects the lower extremities. " -adrenergic denervation hypersensitivity results. A second explanation invokes decreased - receptor sensitivity; a third

82. NEJM -- The Neuropathic Postural Tachycardia Syndrome
Background The postural tachycardia syndrome is a common disorder that Reflex vascular defects in the orthostatic tachycardia syndrome of adolescents.
http://content.nejm.org/cgi/content/abstract/343/14/1008
HOME SEARCH CURRENT ISSUE PAST ISSUES ... HELP Please sign in for full text and personal services Previous Volume 343:1008-1014 October 5, 2000 Number 14 Next The Neuropathic Postural Tachycardia Syndrome
Giris Jacob, M.D., D.Sc., Fernando Costa, M.D., John R. Shannon, M.D., Rose Marie Robertson, M.D., Mark Wathen, M.D., Michael Stein, M.D., Italo Biaggioni, M.D., Andy Ertl, Ph.D., Bonnie Black, R.N., and David Robertson, M.D.
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ABSTRACT Background The postural tachycardia syndrome is a common disorder that is characterized by chronic orthostatic symptoms and a dramatic increase in heart rate on standing, but that does not involve orthostatic hypotension. Several lines of evidence indicate that this disorder may result from sympathetic denervation of the legs. Methods We measured norepinephrine spillover (the rate of entry of norepinephrine into the venous circulation) in the arms and legs both before and in response to exposure to three stimuli (the cold pressor test, sodium nitroprusside infusion, and tyramine

83. Postural Orthostatic Tachycardia
postural orthostatic tachycardia. Healthline Questions and Answers posturalorthostatic tachycardia syndrome patient s report on causes, symptoms,
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    84. CFIDS
    postural tachycardia syndrome (POTS). Neurology. 1995;45S1925. posturalorthostatic tachycardia and chronic fatigue a distinct subset of
    http://www.cfids.org/about-cfids/orthostatic-intolerance.asp
    Symptoms Diagnosis Related Conditions Do I Have CFIDS? ... Profiles Diagnosis: Orthostatic Intolerance (OI) Orthostatic intolerance (OI) is the development of symptoms while standing or sitting upright. It has been associated with chronic fatigue and immune dysfunction syndrome (CFIDS) in both adults and children. The connection between OI and CFIDS was first introduced in 1995, by Rowe and associates at Johns Hopkins University, who identified neurally mediated hypotension (NMH) in CFIDS patients. Since 1995, scientists have learned much more about the broader problem of OI in CFIDS, of which NMH is just one form. It is now thought that many CFIDS patients (up to 97% in some studies) have some form of OI and it seems to be a particular problem in youth with CFIDS. Types of OI
    There are many types of OI, but two forms have been linked with CFIDS in research studies: NMH and postural orthostatic tachycardia syndrome (POTS). NMH is a precipitous drop (at least 20-25 mm Hg) in systolic blood pressure when standing. The blood pressure drop is accompanied or preceded by an increase in symptoms. POTS is a rapid increase in heart rate (pulse) of more than 30 beats per minute (bpm) from baseline, or to more than 120 bpm total, during the first 10 minutes of standing.

    85. ORTHOSTATIC HYPOTENSION
    Positional orthostatic tachycardia (POT) syndrome. Here, the pulse races on standing . Quality of life in patients with postural tachycardia syndrome.
    http://www.dizziness-and-balance.com/disorders/medical/orthostatic.html
    ORTHOSTATIC HYPOTENSION
    Timothy C. Hain, MD. Please read our Return to Index Page last modified: September 4, 2005 Orthostasis means upright posture, and hypotension means low blood pressure. Thus, orthostatic hypotension consists of symptoms of dizziness, faintness or lightheadedness which appear only on standing, and which are caused by low blood pressure. Only rarely is spinning vertigo caused by orthostasis. Symptoms that often accompany orthostatic hypotension include chest pain, trouble holding the urine, impotence, and dry skin from loss of sweating.
    What Causes Orthostatic Hypotension ?
    Blood pressure is maintained by a combination of several things. The heart is the central pump, and a weak or irregular heart can cause orthostasis. Conditions such as arrhythmia, heart failure, deconditioning, and pregnancy are examples where the heart may not be up to the task of providing an adequate blood pressure. The heart pumps blood, and if there is too little blood volume (anemia, dehydration, dialysis), the pressure drops. The blood vessels in the body also can squeeze (constrict) to raise blood pressure, and if this action is paralyzed, blood pressure may fall. Numerous medications affect blood vessels including most of the medications used for blood pressure, and many of the medications used in psychiatry and for anginal heart pain. Heat, such as a hot shower or from a fever can also dilate blood vessels and cause orthostasis. The nervous system senses and responds to regulate blood pressure. If something is wrong in this control system, blood pressure may fluctuate.

    86. Anesthesiology - Fulltext: Volume 93(2) August 2000 P 571-573 Perioperative Cons
    Hoeldtke RD, Davis KM The orthostatic tachycardia syndrome Evaluation of Rosen S, Cryer P postural tachycardia syndrome. Am J Med 1982; 7284750
    http://www.anesthesiology.org/pt/re/anes/fulltext.00000542-200008000-00041.htm
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    References (17) View full size inline images Anesthesiology Volume 93(2) August 2000 pp 571-573
    Perioperative Considerations in a Patient with Orthostatic Intolerance Syndrome
    Mchaourab, Ali M.D.*; Mazzeo, Anthony J. M.D.†; May, Judith A. M.D.†; Pagel, Paul S. M.D., Ph.D.‡ *Resident. †Assistant Professor. ‡Professor and Director of Cardiac Anesthesia. Individual article reprints may be purchased through the Journal Web site, http://www.anesthesiology.org Received from the Department of Anesthesiology, the Medical College of Wisconsin and the Clement J. Zablocki Veterans Affairs Medical Center, Milwaukee, Wisconsin. Submitted for publication December 16, 1999. Accepted for publication April 3, 2000. Address reprint requests to Dr. Pagel: Department of Anesthesiology, Medical College of Wisconsin, MEB-M4280, 8701 Watertown Plank Road, Milwaukee, Wisconsin 53226. Address electronic mail to: atredeau@mcw.edu ORTHOSTATIC intolerance syndrome is an unusual autonomic nervous system disorder characterized by episodic or postural tachycardia that occurs independent of alterations in arterial blood pressure and is associated with symptoms that include palpitations, tremulousness, light-headedness, fatigue, and syncope.

    87. Orthostatic Intolerance In Adolescent Chronic Fatigue Syndrome -- Stewart Et Al.
    NMH in CFS often takes the form of the orthostatic tachycardia syndrome. 1993; 43132137 Abstract; Low PA Et al postural tachycardia syndrome (POTS).
    http://pediatrics.aappublications.org/cgi/content/full/103/1/116
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    This Article Abstract Full Text (PDF) P ... Citation Map Services E-mail this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal ... Cited by other online articles PubMed PubMed Citation Articles by Stewart, J. M. Articles by Munoz, J. Related Collections Office Practice PEDIATRICS Vol. 103 No. 1 January 1999, pp. 116-121
    Orthostatic Intolerance in Adolescent Chronic Fatigue Syndrome
    Julian M. Stewart Michael H. Gewitz Amy Weldon Nina Arlievsky Karl Li and Jose Munoz From the Department of Pediatrics, Divisions of Cardiology, and Immunology and Infectious Disease, New York Medical College, Valhalla, New York.
    ABSTRACT Top
    Abstract
    Methods
    Results
    Discussion
    References Objectives. To demonstrate the association between orthostatic intolerance and the chronic fatigue syndrome (CFS) in adolescents and to delineate the form that orthostatic intolerance takes in these children.

    88. Postural Tachycardia Syn (POTS)
    TI Comparison of the postural tachycardia syndrome (POTS) with orthostatichypotension orthostatic dizziness, tremulousness, tachycardia and variable
    http://neuro-www.mgh.harvard.edu/neurowebforum/AutonomicArticles/1.15.9710.47PMP
    Postural Tachycardia Syn (POTS)
    This article submitted by Don Ball on 1/15/97.
    Author's Email: balld@vt.edu
    Medline Search 1/15/97 POSTURAL and TACHYCARDIA
    UI - 95265154
    AU - Low PA
    AU - Opfer-Gehrking TL
    AU - Textor SC
    AU - Benarroch EE
    AU - Shen WK
    AU - Schondorf R
    AU - Suarez GA AU - Rummans TA TI - Postural tachycardia syndrome (POTS). RF - REVIEW ARTICLE: 48 REFS. AD - Department of Neurology, Mayo Clinic, Rochester, MN 55905, USA. AB - In orthostatic intolerance, the patient develops symptoms while standing that are relieved when the patient assumes a supine position. Different degrees of orthostatic intolerance exist, but not a system of grading severity. We have developed a system that grades the severity of orthostatic intolerance by the three-pronged criteria of the rapidity of development and the severity of orthostatic symptoms, the ability of the subject to withstand orthostatic stresses, and the degree of interference with daily living. In this article, this system is presented, and one disorder, postural tachycardia syndrome (POTS), is examined

    89. Vascular Perturbations In The Chronic Orthostatic Intolerance Of The Postural Or
    Microvascular Filtration Is Increased in postural tachycardia syndrome Reflex vascular defects in the orthostatic tachycardia syndrome of adolescents
    http://jap.physiology.org/cgi/content/abstract/89/4/1505
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    PubMed PubMed Citation Articles by Stewart, J. M. Articles by Weldon, A. Vol. 89, Issue 4, 1505-1512, October 2000
    Vascular perturbations in the chronic orthostatic intolerance of the postural orthostatic tachycardia syndrome
    Julian M. Stewart and Amy Weldon Departments of Pediatrics and Physiology, Center for Pediatric Hypotension, New York Medical College, Valhalla, New York 10595 Chronic orthostatic intolerance is often related to the postural orthostatic tachycardia syndrome (POTS). POTS is characterized by upright tachycardia. Understanding of its pathophysiology remains

    90. Mayo Clinic Proceedings
    Comparison of the postural tachycardia syndrome (POTS) with orthostatic hypotensiondue to autonomic failure. J Auton Nerv Syst. 1994;50181188.
    http://www.mayoclinicproceedings.com/inside.asp?AID=54&UID=

    91. The American Journal Of The Medical Sciences
    I. Idiopathic orthostatic intolerance and postural tachycardia syndromes. The orthostatic tachycardia syndrome evaluation of autonomic function and
    http://www.cfids-cab.org/MESA/Streeten.html
    The American Journal of the Medical Sciences Volume 320(1) July 2000 pp 1-8
    The Roles of Orthostatic Hypotension, Orthostatic Tachycardia, and Subnormal Erythrocyte Volume in the Pathogenesis of the Chronic Fatigue Syndrome
    Streeten, David H. P. MB, DPhil, FRCP; Thomas, Deaver MD; Bell, David S. MD From the Departments of Medicine (ds) and Radiology (dt), State University of New York Health Science Center, Syracuse, New York; and private practice (dsb), Lyndonville, New York. Supported by the Clinical Research Unit of the SUNY Health Science Center, Syracuse, and by a grant from the Wahrsager Foundation. Submitted September 24, 1999; accepted in revised form December 17, 1999. Correspondence: David H.P. Streeten, M.B., D.Phil., Department of Medicine, SUNY Health Science Center, 750 E. Adams Street, Syracuse, NY 13210, phone (315) 464-5722, FAX (315) 464-5718.
    Abstract
    Background: Orthostatic hypotension during upright tilt is an important physical disorder in patients with chronic fatigue syndrome. We have tested its occurrence during prolonged standing, whether it is correctable, and whether reduced circulating erythrocyte volume is present. Methods : Fifteen patients were randomly selected from a large population of patients with chronic fatigue syndrome, studied, and observed for several years (by DSB). Blood pressure (BP) and heart rate (HR) measured with Dinamap every minute for 30 minutes supine and 60 minutes standing were compared with these findings in 15 healthy age- and gender-matched control subjects and later during lower body compression with military antishock trousers (MAST). Plasma catecholamines and circulating erythrocyte and plasma volumes were also measured by isotopic dilution methods.

    92. Local Vascular Responses Affecting Blood Flow In Postural Tachycardia Syndrome -
    postural tachycardia syndrome (POTS) is defined by orthostatic intoleranceassociated with abnormal upright tachycardia. Some patients have defective
    http://ajpheart.physiology.org/cgi/content/abstract/285/6/H2749
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    Am J Physiol Heart Circ Physiol 285: H2749-H2756, 2003. First published August 14, 2003; doi:10.1152/ajpheart.00429.2003
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    PubMed PubMed Citation Articles by Stewart, J. M. Articles by Montgomery, L. D.
    Local vascular responses affecting blood flow in postural tachycardia syndrome
    Julian M. Stewart, Marvin S. Medow, and Leslie D. Montgomery Department of Pediatrics and Physiology, New York Medical College, Valhalla, New York 10595; and LDM Associates, San Jose, California 95126 Submitted 6 May 2003 ; accepted in final form 7 August 2003

    93. Postural Tachycardia Syndrome (POTS) -- Low Et Al. 45 (4): 19 -- Neurology
    orthostatic headaches without CSF leak in postural tachycardia syndrome Neurology,October 14, 2003; 61(7) 980 982. Abstract Full Text PDF
    http://www.neurology.org/cgi/content/abstract/45/4/S19
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    Postural tachycardia syndrome (POTS) PA Low, TL Opfer-Gehrking, SC Textor, EE Benarroch, WK Shen, R Schondorf, GA Suarez and TA Rummans
    Department of Neurology, Mayo Clinic, Rochester, MN 55905, USA. In orthostatic intolerance, the patient develops symptoms while standing that are relieved when the patient assumes a supine position. Different degrees of orthostatic intolerance exist, but not a system of grading severity. We have developed a system that grades the severity of orthostatic intolerance by the three-pronged criteria of the rapidity of development and the severity of orthostatic symptoms, the ability of the

    94. Neurology -- Sign In Page
    orthostatic headaches without CSF leak in postural tachycardia syndrome Instead, they were found to have postural tachycardia syndrome (POTS),
    http://www.neurology.org/cgi/content/full/61/7/980
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    Orthostatic headaches without CSF leak in postural tachycardia syndrome
    Mokri and Low Neurology.
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    95. Microvascular Filtration Is Increased In Postural Tachycardia Syndrome -- Stewar
    Background— postural tachycardia syndrome (POTS) is related to defective Chronic orthostatic intolerance is associated with postural tachycardia
    http://circ.ahajournals.org/cgi/content/full/107/22/2816
    Published online before print May 19, 2003, doi:10.1161/01.CIR.0000070951.93566.FC
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    01.CIR.0000070951.93566.FCv1
    Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal ... Request Permissions PubMed PubMed Citation Articles by Stewart, J. M. Related Collections Autonomic, reflex, and neurohumoral control of circulation Circulation.
    Clinical Investigation and Reports
    Microvascular Filtration Is Increased in Postural Tachycardia Syndrome
    Julian M. Stewart, MD, PhD From the Department of Pediatrics and Physiology, New York Medical College, Valhalla, NY. Correspondence to Julian M. Stewart, MD, PhD, Professor of Pediatrics and Physiology, Suite 618, Munger Pavilion, New York Medical College, Valhalla, NY 10595. E-mail
    Abstract Top
    Abstract
    Introduction
    Methods
    Results
    Discussion
    References Postural tachycardia syndrome (POTS) is related to defective peripheral vasoconstriction of dependent extremities with redistributive hypovolemia.

    96. Hyperadrenergic Postural Tachycardia Syndrome In Mast Cell Activation Disorders
    postural tachycardia syndrome (POTS) is a disabling condition that commonly Because of the prominent orthostatic tachycardia, ßblockers are commonly
    http://hyper.ahajournals.org/cgi/content/full/45/3/385
    Published online before print February 14, 2005, doi:10.1161/01.HYP.0000158259.68614.40
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    01.HYP.0000158259.68614.40v1
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    Hypertension.
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    Hyperadrenergic Postural Tachycardia Syndrome in Mast Cell Activation Disorders
    Cyndya Shibao Carmen Arzubiaga L. Jackson Roberts, II Satish Raj Bonnie Black Paul Harris Italo Biaggioni
    From the Division of Clinical Pharmacology, Department of Medicine and Pharmacology, and the Autonomic Dysfunction Center, Vanderbilt University School of Medicine, Nashville, Tenn. Correspondence to Italo Biaggioni, MD, 1500 21st Ave S, Suite 3500, Clinical Trials Center, Vanderbilt University, Nashville, TN 37212. E-mail

    97. Hyperadrenergic Postural Tachycardia Syndrome In Mast Cell Activation Disorders
    postural tachycardia syndrome (POTS) is a disabling condition that commonly hyperadrenergic response to posture, with orthostatic tachycardia (from 79±4
    http://hyper.ahajournals.org/cgi/content/abstract/45/3/385
    Published online before print February 14, 2005, doi:10.1161/01.HYP.0000158259.68614.40
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    Autonomic, reflex, and neurohumoral control of circulation
    Hypertension.
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    Hyperadrenergic Postural Tachycardia Syndrome in Mast Cell Activation Disorders
    Cyndya Shibao Carmen Arzubiaga L. Jackson Roberts, II Satish Raj Bonnie Black Paul Harris Italo Biaggioni
    From the Division of Clinical Pharmacology, Department of Medicine and Pharmacology, and the Autonomic Dysfunction Center, Vanderbilt University School of Medicine, Nashville, Tenn. Correspondence to Italo Biaggioni, MD, 1500 21st Ave S, Suite 3500, Clinical Trials Center, Vanderbilt University, Nashville, TN 37212. E-mail

    98. The Orthostatic Tachycardia Syndrome: Evaluation Of Autonomic Function And Treat
    The orthostatic tachycardia syndrome evaluation of autonomic function andtreatment with octreotide and The Neuropathic postural tachycardia syndrome
    http://jcem.endojournals.org/cgi/content/abstract/73/1/132

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    The orthostatic tachycardia syndrome: evaluation of autonomic function and treatment with octreotide and ergot alkaloids
    RD Hoeldtke and KM Davis
    Department of Medicine, Temple University School of Medicine, Philadelphia, Pennsylvania 19140. Orthostatic tachycardia is a poorly understood syndrome in which patients develop dizziness, diaphoresis, or palpitations upon shifting from the supine to the upright posture. The present study was performed to determine whether autonomic neuropathy might be present in these patients, and whether the abnormal hemodynamic response to standing might be the result of failure of reflex vasoconstriction. We measured autonomic function in 9

    99. Familial Orthostatic Tachycardia Due To Norepinephrine Transporter Deficiency --
    orthostatic intolerance (OI) or postural tachycardia syndrome (POTS) is a syndromeprimarily affecting young females, and is characterized by
    http://www.annalsnyas.org/cgi/content/abstract/940/1/527

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    New York Academy of Sciences
    Familial Orthostatic Tachycardia Due to Norepinephrine Transporter Deficiency
    DAVID ROBERTSON a NANCY FLATTEM a TAHIR TELLIOGLU a ROBERT CARSON a EMILY GARLAND a JOHN R. SHANNON a JENS JORDAN b GIRIS JACOB c RANDY D. BLAKELY a and ITALO BIAGGIONI a a Autonomic Dysfunction Center, Vanderbilt University, Nashville, Tennessee 37232-2195, USA
    b Clinical Research Center, Franz Volhard Klinik, Berlin, Germany
    c Recanati Autonomic Dysfunction Center, Rambam Medical Center, Haifa, Israel
    Address for correspondence: David Robertson, M.D., Autonomic Dysfunction Center, AA3228 MCN, Vanderbilt University, Nashville, TN 37232-2195. Voice: 615-343-6499; fax: 615-343-8649.
    Orthostatic intolerance (OI) or postural tachycardia syndrome (POTS) is a syndrome primarily affecting young females, and

    100. JW Neurology -- Sign In
    postural tachycardia syndrome (POTS) is characterized by orthostatic tachycardiaand symptoms of intolerance without orthostatic hypotension.
    http://neuro.jwatch.org/cgi/content/full/2000/1122/4

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