Pediatric Heart Expert Forum
POTS
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Questions in this forum are answered by pediatric cardiologists, cardiothoracic surgeons and anesthesiologists from The Children's Hospital of Philadelphia. This forum is for questions and support about pediatric heart problems, symptoms and topics such as heart murmurs, palpitations, fainting, chest pain, congenital heart defects (including management and intervention), fetal cardiology, adult congenital cardiology, arrhythmias and pre-participation athletic screening.

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POTS

Dear Doctor Borris: My 14 year old daughter was recently diagnosed after 9 months of a number of tests!!! She was placed on beta blockers (betaloc zoc) on September 9th 2013, the dosage was 25mg divided in 2 takes a day: 8am / pm. We increased  water/Gatorade intake to 2-4 liters a day, placed bed at  angle, increased salt intake to 4 to 5 grams , she continued exercising, adapted diet to needs.  she continued to have tachycardia at least 3 times a week and syncope , loss of consciousness of approx. 30 sec to 60 sec. increased dosage betaloc zoc  50mg per day 2 takes am/pm ,did not help either. continued with tachycardia & syncope, fainting spells increased to 2 min .  taken off all meds 3  weeks (gradually)  to run a tilt test , new holter test & blood pressure map test Electrophysiologists changed meds 10/18/13. given Inderal (propranolol)20mg /day  8am/8pm & prozac  (fluoxetine)  taken off prozac, made sympotoms worse ; tachycardia, vomite &  syncope ,unconscious for over 4 min.
Read about dysautonomia & POTS. Keep reading heart rate changes 30 beats or more when changing from one position to another: but she has almost always had tachycardia when sitting at school in class, not when she gets up, always while sitting. Some of her syncope’s don’t have symptoms; she just loses consciousness without warning. The other thing that puzzles me is that she is able to exercise, she never faints while exercising or feels tachycardia. Before she was diagnosed she was jogging and surfing!!! (Surfing has now been restricted by her Dr). she has always been extremely active.

Live in Lima Peru, would fly up to states if can get an appointment with you for evaluation. How much would this cost? She goes back to school the first week of March 2014.  
I hope you will be able to answer back to us promptly.  
773637_tn?1327450515
Dear Irina Biffi,

I am not able to manage these patients through a website like this.  However, I would refer you to our Cardiac Center Nurse Navigators link on our website (http://heart.chop.edu) to get your questions answered.
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The Children’s Hospital of Philadelphia
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