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January 1, 1993

Idiopathic postural orthostatic tachycardia syndrome
An attenuated form of acute pandysautonomia?

January 1993 issue
43 (1_part_1) 132


To characterize the idiopathic postural orthostatic tachycardia syndrome (POTS), we reviewed the records of all patients aged 20 to 51 who presented to the Mayo Autonomic Reflex Laboratory and who exhibited tachycardia at rest or during head-up tilt. These patients were usually women who experienced an acute onset of persistent lightheadedness and fatigue or gastrointestinal dysmotility. In seven patients, a viral illness may have preceded the onset of symptoms. In two instances, signs and symptoms of a small-fiber sensory neuropathy were present. Laboratory evaluation of autonomic function revealed increased diastolic blood pressure to tilt (5/16), increased Valsalva ratio, marked decrease in phase II of the Valsalva maneuver with normal phase IV overshoot, and normal forced respiratory sinus arrhythmia. Abnormal quantitative sudomotor axon reflex test and thermoregulatory sweat test and an excessive orthostatic increase of catecholamines were found in some patients. We conclude that in many instances POTS may be a manifestation of a mild form of acute autonomic neuropathy.

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Published In

Volume 43Number 1_part_1January 1993
Pages: 132
PubMed: 8423877

Publication History

Published online: January 1, 1993
Published in print: January 1993


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Affiliations & Disclosures

Ronald Schondorf, PhD, MD
Department of Neurology (Dr. Schondorf), McGill University, Sir Mortimer B. Davis Jewish General Hospital, Montréal, Québec, Canada; and the Department of Neurology (Dr. Low), Mayo Clinic and Foundation, Rochester, MN.
Phillip A. Low, MD
Department of Neurology (Dr. Schondorf), McGill University, Sir Mortimer B. Davis Jewish General Hospital, Montréal, Québec, Canada; and the Department of Neurology (Dr. Low), Mayo Clinic and Foundation, Rochester, MN.

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  1. COVID-19 Induced Postural Orthostatic Tachycardia Syndrome (POTS): A Review, Cureus, (2023).
  2. Postural Orthostatic Tachycardia Syndrome in COVID-19: A Contemporary Review of Mechanisms, Clinical Course and Management, Vascular Health and Risk Management, Volume 19, (303-316), (2023).
  3. Postural Orthostatic Tachycardia Syndrome: Diagnosis and Management Guide for Nurses, Nursing: Research and Reviews, Volume 13, (41-49), (2023).
  4. Autonomic dysfunction in patients with orthostatic dizziness, Annals of Clinical Neurophysiology, 25, 1, (27-31), (2023).
  5. Cardiorespiratory dysautonomia in post‐COVID‐19 condition: Manifestations, mechanisms and management, Journal of Internal Medicine, 294, 5, (548-562), (2023).
  6. Exploring the complexities of illness identity and symptom management in seeking a diagnostic label of postural orthostatic tachycardia syndrome (POTS): An inductive approach, British Journal of Health Psychology, (2023).
  7. Postural orthostatic tachycardia syndrome: New concepts in pathophysiology and management, Trends in Cardiovascular Medicine, 33, 2, (65-69), (2023).
  8. Autonomic Dysfunction Related to Postacute SARS-CoV-2 Syndrome, Physical Medicine and Rehabilitation Clinics of North America, 34, 3, (563-572), (2023).
  9. Pooled rates and demographics of POTS following SARS-CoV-2 infection versus COVID-19 vaccination: Systematic review and meta-analysis, Autonomic Neuroscience, 250, (103132), (2023).
  10. Validation of symptom measures in patients under investigation for postural orthostatic tachycardia syndrome (POTS): The Orthostatic Grading Scale (OGS) and the Symptom Screen for Small-fiber Polyneuropathy (SSS), Autonomic Neuroscience, 250, (103130), (2023).
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