Treatment questions in POTS with hypertension and syncope |
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Authors: | Malgorzata Lelonek Jan Henryk Goch |
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Institution: | (1) Department of Cardiology, Chair of Cardiology and Cardiac Surgery, Medical University of Lodz, 91-425 Lodz, Poland |
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Abstract: | A 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. |
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Keywords: | Syncope POTS Hypertension |
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