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Heart Disease  (Expert Forum)
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Orthrostatic tachycardia
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Orthrostatic tachycardia

by Robert, Apr 18, 2001 12:00AM
I don't know if you can direct me to where I can find an answer.  I have looked through the forum of questions and I found no answers.  I want to know what they can do about Orthrostatic tachycardia.  It is a very bad problem that no one but my endocrinologist wants to address but he has to go through my primary care physcian.  That was a year ago and nothing has been done.  I just wanted to know if there is a device that can control my heart beat down to a regular beat.  Resting it is about 100, up it jumps to 130 to 160 and don't know how high it was when I almost passed out in the bath tub.



THanks



by CCF-M.D.-CRC, Apr 19, 2001 12:00AM


Dear Robert,



Postural orthostatic tachycardia syndrome (POTS) is a form of autonomic dysfunction  that presents with symptoms of postural tachycardia and lightheadedness, disabling fatigue, exercise intolerance, dizziness, and near syncope. During baseline tilt table testing  patients demonstrate a heart rate increase of > or = 30 beats/min (or a maximum heart rate of 120 beats/min) within the first 10 minutes upright (unassociated with profound hypotension), which reproduction of their symptom complex. In addition these patients exhibit an exaggerated response to isoproterenol infusions.  Treatment may include lifestyle changes and/or medications such as beta-blockers.  We have a specialist here in the area of autonomic function that deals with this condition.  If you would like to be seen at the Cleveland Clinic call the number below and ask to make an appointment with Dr. Fouad in the syncope clinic.



Here are some resources for POTS sufferers.



Web sites.



National Dysautonomia Research Foundation http://www.ndrf.org



Doctors who are educated in the diagnosis and treatment of POTS. http://www.ndrf.org/physicia.htm



Johns Hopkins Hospital neurally mediated hypertension Treatment



http://ww2.med.jhu.edu/peds/cfs.html



Chronic Fatigue Syndrome News



http://www.cais.com/cfs-news



The American Journal of Medicine special report on chronic

fatigue syndrome in AM J Med 1998 Sep28;105(3A)



http://www.cais.com/cfs-news/ajm98.htm  





Articles:



"The postural orthostatic tachycardia syndrome: a neurocardiogenic variant identified during head-up tilt table testing. By  Grubb BP. Kosinski DJ. Boehm K. Kip K.  In Pacing & Clinical Electrophysiology. 20(9 Pt 1):2205-12, 1997 Sep.



"Postural Tachycardia Syndrome (POTS)", by doctors Phillip Low,

Opfer-Gehrking, Textor, Benarroch, Shen, Schondorf, Suarez,

and Rummans. Neurology April 1995;45(4 Suppl 5):S19-S25



"Orthostatic Intolerance and Orthostatic Tachycardia",  guest editor of

special symposium issue on orthostatic intolerance David

Robertson, M.D.,  The American Journal of Medical Sciences February

1999;317:#2: 75-124  



"Management of Chronic Orthostatic Hypotension", by doctors Jack Onrot,

Goldberg, Hollister, Biaggioni, RM Robertson and

David Robertson of Vanderbilt University.  American Journal of Medicine

March 1986;80:454-464

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