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Postural tachycardia syndrome

Horacio Kaufmann, MD
Roy Freeman, MD
Section Editor
Michael J Aminoff, MD, DSc
Deputy Editor
Janet L Wilterdink, MD


Symptomatic falls in blood pressure after standing or eating are a frequent clinical problem, particularly in the elderly. The symptoms are often due to cerebral hypoperfusion and include generalized weakness, dizziness or lightheadedness, visual blurring or darkening of the visual fields, and, in severe cases, loss of consciousness. These patients often have a decrease in sympathetic activity that leads to systemic hypotension with standing.

Another form of orthostatic intolerance occurs in patients, particularly younger adults and children, who consistently or frequently experience symptoms of orthostatic intolerance in response to postural stressors. Autonomic reflexes are relatively preserved in these patients, and orthostatic hypotension and syncope rarely occur. Some patients may have slightly elevated blood pressure. The hallmark of this disorder is an exaggerated heart rate increase in response to postural change. This disorder has been called the postural tachycardia syndrome or POTS [1-3].

The nosology of POTS is confusing; several similar terms have been used to describe the disorder:

Chronic orthostatic intolerance

Mild orthostatic intolerance

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Literature review current through: Nov 2017. | This topic last updated: Mar 03, 2015.
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