POTS

[Philips__0]

  I am a 36 yr old Male who has been suffering with bouts of Tachycardia, chest pain and weakness for 22 months.  I have had extensive cardiac workups done, which showed clean coronary arteries.  I have heard about Postural Orthostatic Tachycardia Syndrome and Cronic Fatigue Syndrome, and would like to find out more about this.  I do have orthostatic Tach., and my heartrate jumps 30-40 bpm when I stand up,.  I become very light headed, and very weak.  I find it very hard to do anything exertional, and even getting up to walk across the room is difficult.  Please shed some light on this topic if you can.  How come my doctors have not persued this avenue.  I have no energy at all, and feel that I have cronic faigue.  Thank you for your time and consideration.  My meds are Cardizem 180 2x a day, Toprol 50mg. 1x a day, Ativan, 1mg 3x a day, and Remeron at bedtime.
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Thanks for your questions.  The symptoms described in your message can
be associated with Postural Orthostatic Tachycardia Syndrome (POTS), including
the general fatigue.  Given your symptoms, and the fact that you are taking
an anti-hypertensive (Cardizem), I would consider a formal orthostasis
evaluation called a "tilt-table test".  It basically attempts to reproduce
and evaluate under controlled conditions the onset and evolution of hypotensive/
tachycardia symptoms.
There isn't layman's literature available on this subject, but the following
two references might be found in good university libraries:
1. The postural orthostatic tachycardia syndrome, in
     Pacing Clinic Electrophysiology, Sept 1997, volume 20, pp.2205-2212
2. Postural tachycardia syndrome (POTS), in
     Neurology, April 1995, volume 45, supplement 5, pages S19-S25.
I hope this information is helpful.
This information is provided for general medical education purposes only.
Please consult your doctor regarding diagnostic and treatment options.