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         Postural Orthostatic Tachycardia Syndrome:     more detail
  1. Postural Orthostatic Tachycardia Syndrome: Dysautonomia, Orthostatic Intolerance, Supine Position,Tachycardia, Cerebral Blood Flow, Orthostatic Hypotension

21. Postural Orthostatic Tachycardia Syndrome : Meddie Health Search
enclosed. (Rating 0.00 Votes 0) Rate It. Postural Orthostatic TachycardiaSyndrome Patient's report on causes, symptoms, and treatment.
http://www.meddie.com/search/Health/Conditions_and_Diseases/Neurological_Disorde
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22. ClinicalTrials.gov - Linking Patients To Medical Research Search
Query Details. No studies were found for postural orthostatic tachycardia syndromeALLFIELDS. postural orthostatic tachycardia syndrome , None. Syndrome , 1971.
http://www.clinicaltrials.gov/search/term=Postural Orthostatic Tachycardia Syndr

23. Pediatric Postural Orthostatic Tachycardia Syndrome Journal
Pediatric postural orthostatic tachycardia syndrome. Journal Article Abstracts
http://www.pediatricnetwork.org/medical/OI/oi-citations/pots.htm
for Chronic Fatigue Syndrome, Fibromyalgia, and Orthostatic Intolerance Home News Forum Contribute ... Help
Pediatric Postural Orthostatic Tachycardia Syndrome Journal Article Abstracts

Reviews
  • Grubb BP, Kanjwal MY, Kosinski DJ. Review: The postural orthostatic tachycardia syndrome: current concepts in pathophysiology diagnosis and management. J Interv Card Electrophysiol. 2001 Mar;5(1):9-16. Review. No abstract available
Pathophysiology

24. Orthostatic Intolerance A Syndrome Including Neurally Mediated
Orthostatic Intolerance. A syndrome including neurally mediated hypotension, delayedorthostatic hypotension, and postural orthostatic tachycardia syndrome.
http://www.pediatricnetwork.org/medical/OI/oi-index.htm

25. Rehabilitex, Inc. | Postural Orthostatic Tachycardia Syndrome (POTS)
Astronauts often develop a temporary form of orthostatic tachycardia (rapidheart rate) upon returning to earth due to the deconditioning effect of
http://www.rehabilitex.com/pots.html
Advanced Search The following is a description of some of the signs and symptoms associated with the diagnosis of POTS. This is in no way inclusive of all of the possible signs, symptoms and treatment options. This is only to act as a guide and an educational resource.
Causes
There are many causes or suspected causes of POTS. These are: viral and/or bacterial infections, changes in blood volume (hypovolemia), exposure to toxic chemicals, genetically inherited, diabetes, alcoholism, damage to the vagus nerve (cranial nerve ten) and spinal cord through accidents of all kinds (car accidents being most prevalent), and narrowing of the spinal canal (stenosis) particularly in the upper cervical spine.
Symptoms of POTS
Patient's may become dizzy, lightheaded and develop chest pain from prolonged standing. Shortness of breath, memory disturbances, blurred vision, tingling in the legs, sweating, and feelings of heat are all common symptoms of orthostatic stress. Some patient's may pass out, and many patients may experience spells of vertigo when going from lying down to standing. Numbness in the palms of the hand and soles of feet are also common symptoms. You may experience that your legs, arms and hands can become numb when waking in the morning. Eye pain is another common problem with feelings of pressure behind the eyes. Patient's can become so weak in their eye muscles that they are easily strained and focusing becomes difficult.

26. 1Up Health > Health Links Directory > Conditions And Diseases: Neurological Diso
postural orthostatic tachycardia syndrome Patient's report on causes,symptoms, and treatment. Postural Orthostatic Tachycardia
http://www.1uphealth.com/links/dysautonomia-postural-orthostatic-tachycardia-syn
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Sites Orthostatic Intolerance
An article written by David Robertson, MD explaining this disorder. A list of alternate names which could be used for this or similar disorders is enclosed. Postural Orthostatic Tachycardia Syndrome Patient's report on causes, symptoms, and treatment. Postural Orthostatic Tachycardia Syndrome A definition of POTS and its relation to Chronic Fatigue Syndrome and the pathophysiology. What is Orthostatic Intolerance? An article about orthostatic tachycardia syndrome (POTS). What it is, the prognosis as well as all the names used to refer to this disorder. Help build the largest human-edited directory on the web.

27. 1Up Health > Health Links Directory > Conditions And Diseases: Neurological Diso
Categories. postural orthostatic tachycardia syndrome (4) ShyDrager Syndrome (3). POTSPlace Information on postural orthostatic tachycardia syndrome (POTS).
http://www.1uphealth.com/links/neurological-disorders-dysautonomia.html
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Postural Orthostatic Tachycardia Syndrome

Shy-Drager Syndrome
See Related Categories Health: Conditions and Diseases: Neurological Disorders: Autonomic Nervous System Sites Advocate Health Care In depth information about mitral valve prolapse. Dysautonomia Home Page Designed for people who suffer with all forms of this disorder. Including VVS, NCS, NMH, POTS and various other problems that cause fainting. Joan E. Simms Story A personal story touching on mitral valve prolapse syndrome, TMJ, and chronic fatigue syndrome along with some helpful hints and links. List for Women Instructions on how to receive a weekly newsletter for women with mitral valve prolapse syndrome. Details as to the contents of the newsletter. Living Well with Mitral Valve Prolapse Syndrome Roger Easterbrooks offers information, help for ultra and highly sensitive people, people with anxiety, depression, panic attacks or shyness.

28. CFIDS
JAMA 1995 September 27; 274(12) 961967. postural orthostatic tachycardia syndrome.Stewart JM Transient orthostatic hypotension is common in adolescents.
http://www.cfids.org/youth/articles/medical/nmh.asp
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Chronicle Archives What is CFIDS? What is CFIDS in Youth? Other Resources NMH and OI* in Children and Adolescents
Medical Journal Articles
* NMH=Neurally Mediated Hypotension, OI=Orthostatic Intolerance Following is a list of articles about neurally mediated hypotension and orthostatic intolerance in youth that have been published in the peer-reviewed medical literature. If we have been able to locate the article's abstract on line, we have provided a link to that abstract. If you wish to read an article that does not have a link, please contact your local medical library or hospital. Most of these articles focus on children and adolescents. To read articles about research in adults, do a search on PubMed , the search engine of the National Library of Medicine.
Review Articles and Introductory Materials

29. CFIDS
of OI There are many types of OI, but two forms have been linked with CFIDS inresearch studies NMH and postural orthostatic tachycardia syndrome (POTS).
http://www.cfids.org/about-cfids/orthostatic-intolerance.asp
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... Profiles Diagnosis: Orthostatic Intolerance (OI) Related Information
  • NMH Information Packet
  • OI Research Symposium
  • Orthostatic intolerance (OI) is the development of symptoms while standing or sitting upright. It has been associated with chronic fatigue and immune dysfunction syndrome (CFIDS) in both adults and children. The connection between OI and CFIDS was first introduced in 1995, by Rowe and associates at Johns Hopkins University, who identified neurally mediated hypotension (NMH) in CFIDS patients. Since 1995, scientists have learned much more about the broader problem of OI in CFIDS, of which NMH is just one form. It is now thought that many CFIDS patients (up to 97% in some studies) have some form of OI and it seems to be a particular problem in youth with CFIDS. Types of OI
    There are many types of OI, but two forms have been linked with CFIDS in research studies: NMH and postural orthostatic tachycardia syndrome (POTS). NMH is a precipitous drop (at least 20-25 mm Hg) in systolic blood pressure when standing. The blood pressure drop is accompanied or preceded by an increase in symptoms.

    30. Fainting
    postural orthostatic tachycardia syndrome postural orthostatic tachycardia syndrome(POTS) is clinically defined as a heart rate increase of 30 bpm or more
    http://www.geocities.com/HotSprings/Falls/8173/fainting.html
    Causes of Dizziness
    Common causes of dizziness are Neurally Mediated Hypotension (NMH), Orthostatic Hypotension (OH), inner ear infections and anxiety. Both NMH and OH causes a drop in blood pressure but under different circumstances.
    There are differences in the description of the terms to describe dizziness.
    Faint: feeling weak or as if ready to pass out (may or may not actually pass out) from drop in blood volume in the brain.
    Virtigo: sensation of room spinning from possibly disequalibrium or being off balance.
    Links to Sites for More Information on Causes of Dizziness
    The Vestibular Disorders Association
    Symptoms of vestibular disorders (inner ear problems) may include dizziness, imbalance, vertigo, nausea, and fuzzy vision, and may be accompanied by hearing problems. Other symptoms are often reported.
    Neurosciences on the Internet
    Dizziness and Tinnitus links.
    NEURO-OTOLOGY (VERTIGO, DIZZINESS AND HEARING DISORDERS)
    Site by B. Todd Troost, M.D. gives detailed information on Vertigo, Dizziness and Hearing Disorders.
    Postural Orthostatic Tachycardia Syndrome
    Postural Orthostatic Tachycardia Syndrome (POTS) is clinically defined as a heart rate increase of 30 bpm or more from the supine (laying down) to the standing position within ten minutes or less. Site provides a lot of information and links.

    31. Searchalot Directory For Postural Orthostatic Tachycardia Syndrome
    Sponsored Links. Top Health Conditions and Diseases Neurological DisordersDysautonomia postural orthostatic tachycardia syndrome (4). Related Web Sites.
    http://www.searchalot.com/Top/Health/ConditionsandDiseases/NeurologicalDisorders
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    32. STARS - Syncope Trust And Reflex Anoxic Seizures
    POTS Place A Guide to postural orthostatic tachycardia syndrome This web siteis about a disorder called postural orthostatic tachycardia syndrome (POTS).
    http://www.stars.org.uk/links.html
    STARS - S yncope T rust A nd R eflex anoxic S eizures Links Please Note: While we may recommend sites to you, we CANNOT be held responsible for information that you may collect from these sites. Neuroscience for Kids Neuroscience for Kids has been created for all students and teachers who would like to learn about the nervous system. The Children's Heart Institute
    The Children's Heart Institute has pediatric cardiology facilities in the United States that provide comprehensive diagnostic and therapeutic services. This link gives a excellent description of syncope, the medical term for fainting. NCVO
    The National Council for Voluntary Organisations (NCVO) works with and for the voluntary sector in England by providing information, advice and support and by representing the views of the sector to government and policy-makers. DYNAkids
    (Dysautonomia Youth Network of America, Inc.)
    Due to the impact of their condition, young people with dysautonomia may experience isolation from their peers. Often they must make life style changes in the prime of their life. Obviously, it can be very stressful, traumatic, and life impacting for the entire family. DYNA is a not for profit organization dedicated to serving these individuals. POTS Place: A Guide to Postural Orthostatic Tachycardia Syndrome
    This web site is about a disorder called postural orthostatic tachycardia syndrome (POTS). This disorder is characterized by the body's inability to make the necessary adjustments to counteract gravity when standing up. This site provides an overview of POTS and contains sections on symptoms, mechanisms, causes, tests, myths, links, research and newsletters.

    33. Orthostatic Intolerance
    An article written by David Robertson, MD explaining this disorder. A list of alternate names which Category Health Conditions and Diseases...... Intolerance Syndromes Hyperadrenergic orthostatic hypotension Orthostatic tachycardiasyndrome postural orthostatic tachycardia syndrome Postural tachycardia
    http://www.biotech.vt.edu/ncs_homepage/OrthoIntol.html
    Orthostatic Intolerance
    David Robertson, MD
    Vanderbilt University Nashville Tennessee Orthostatic intolerance
    is present when patients experience symptoms such as lightheadedness, palpitations, tremulousness, and poor concentration during standing. Many patients also note other symptoms with upright posture: visual changes, discomfort in the head or neck, throbbing of the head, poor concentration, tiredness, weakness and occasionally fainting. For many years, such patients were felt to have deconditioning and were encouraged to pursue a more vigorous exercise regimen. However, recently it has become clear that many individuals with these symptoms have a more serious problem than mere deconditioning. Indeed, a number of cardiovascular and autonomic abnormalities have recently been detected. These include, in some patients, a reduced blood volume, excessive loss of plasma from the blood vessels on standing, excessive salt loss through the kidney, and abnormalities in the function of the autonomic (involuntary) nervous system. However, not every patient has all these abnormalities.
    Heterogeneity.

    34. Untitled
    ) Chronic Orthostatic Intolerance and the postural orthostatic tachycardia syndrome(Our work on COI, CFS, and POTS) The orthostatic tachycardia syndrome is a
    http://dysautonomia.homestead.com/files/POTS_ex_w_graph.txt
    ) Chronic Orthostatic Intolerance and the Postural Orthostatic Tachycardia Syndrome (Our work on COI, CFS, and POTS)
    Patients with the syndrome display an unusual amount of pooling in the lower extremities often associated with acrocyanosis. The literature contains a number of potential explanations for abnormal venous pooling and fluid collection in COI-POTS including impaired innervation of the veins or in their response to sympathetic stimulation. One such explanation favors an autonomic neuropathy that predominantly affects the lower extremities. "1-adrenergic denervation hypersensitivity results. A second explanation invokes decreased $1- receptor sensitivity; a third,
    Our preliminary data  ( Circulatory Findings in POTS and CFS suggest the hypothesis that blood pooling in COI-POTS always results from a defect in arterial vasoconstriction during orthostasis causing increased venous filling and enhanced microvascular filtration. Blood is redistributed peripherally and redistribution is enhanced during orthostasis producing increased microvascular filtration and dependent edema. Central hypovolemia causes reflex tachycardia, reduced cerebral blood flow and often hypotension. COI-POTS results in a circulation at high risk for simple fainting by virtue of a depleted thoracic vascular bed. In many ways it resembles hemorrhage or hypovolemia in that tachycardia and malperfusion are first noted which may then proceed to hypotension or loss of consciousness or both.
    Effective treatment for chronic orthostatic intolerance is being developed but will depend on specific etiologies as these are discovered. For the moment we continue to use some of the medications outlined in the vasovagal section. Of these florinef and midodrine seem to be most effective with an emerging use of SSRI’s. Beta-blockers and clonidine are rarely tolerated and may point to a very different origin for COI from syncope.

    35. Coi
    postural orthostatic tachycardia syndrome gives an excellent overview of dysautonomiaand is particularly strong in explaining cervical stenosis and Chiari
    http://home.bluecrab.org/~health/coi/coi.html
    Chronic Orthostatic Intolerance (COI) Also called:
    • D ysautonomia Neurally Mediated Hypotension (NMH) Neurally Mediated Syncope Orthostatic syncope Postural Tachycardia Syndrome (POTS)

    In all of these conditions, upright posture makes the person sick. Walking and running are actually easier than standing or sitting still. The symptoms caused by standing or sitting may include any of the following: fainting, dizziness, nausea, feeling very tired, feeling excessively jittery, having difficulty concentrating or remembering things, experiencing pain in the lower parts of the abdomen or in the legs, mottling or purpling of hands, ankles, feet and legs, hot flushes, sweating, and headache. The underlying cause is a disruption of the autonomic nervous system. This system automatically regulates bodily functions, including heart rate and blood pressure. It also responds to postural or orthostatic stress. Blood is a liquid. It tries to flow downward. When you are standing it tends to run into your legs and feet. This deprives your upper body and, especially, your brain, of an adequate blood supply. The autonomic nervous system prevents this by regulating how the heart beats and by constricting blood vessels in the lower parts of the body, forcing blood upward. In people with COI, this system doesn't work right and blood tends to pool in the belly, legs, and feet. It will pool in the hands, too, if the arms are dangling. This is what causes the mottling or purpling of the skin usually seen in COI..

    36. Www.cfs.inform.dk/Coicfs/stewart00.txt
    Date sent Sat, 12 Aug 2000 Autonomic nervous system dysfunction in adolescents withpostural orthostatic tachycardia syndrome and chronic fatigue syndrome is
    http://www.cfs.inform.dk/Coicfs/stewart00.txt
    Date sent: Sat, 12 Aug 2000 Autonomic nervous system dysfunction in adolescents with postural orthostatic tachycardia syndrome and chronic fatigue syndrome is characterized by attenuated vagal baroreflex and potentiated sympathetic vasomotion. Pediatr Res 2000 Aug;48(2):218-26 Stewart JM Department of Pediatrics, The Center for Pediatric Hypotension, New York Medical College, Valhalla 10595, USA. PMID: 10926298, UI: 20380311 The objective was to determine the nature of autonomic and vasomotor changes in adolescent patients with orthostatic tachycardia associated with the chronic fatigue syndrome (CFS) and the postural orthostatic tachycardia syndrome (POTS). Continuous electrocardiography and arterial tonometry was used to investigate the heart rate and blood pressure responses before and 3-5 min after head-up tilt in 22 adolescents with POTS and 14 adolescents with CFS, compared with control subjects comprising 10 healthy adolescents and 20 patients with simple faint. Heart rate and blood pressure variability, determined baroreceptor function using transfer function analysis, and measured cardiac vagal and adrenergic autonomic responses were calculated using timed breathing and the quantitative Valsalva maneuver. Two of 10 healthy controls and 14 of 20 simple faint patients experienced vasovagal syncope during head-up tilt. By design, all CFS and POTS patients experienced orthostatic tachycardia, often associated with hypotension. R-R interval and heart rate variability were decreased in CFS and POTS patients compared with control subjects and remained decreased with head-up tilt. Low-frequency (0.05-0.15 Hz) blood pressure variability reflecting vasomotion was increased in CFS and POTS patients compared with control subjects and increased further with head-up tilt. This was associated with depressed baroreflex transfer indicating baroreceptor attenuation through defective vagal efferent response. Only the sympathetic response remained. Heart rate variability declined progressively from normal healthy control subjects through syncope to POTS to CFS patients. Timed breathing and Valsalva maneuver were most often normal in CFS and POTS patients, although abnormalities in select individuals were found. Heart rate and blood pressure regulation in POTS and CFS patients are similar and indicate attenuated efferent vagal baroreflex associated with increased vasomotor tone. Loss of beat-to-beat heart rate control may contribute to a destabilized blood pressure resulting in orthostatic intolerance. The dysautonomia of orthostatic intolerance in POTS and in chronic fatigue are similar.

    37. AHMF: 98 Conference: Rowe
    been variously termed neurally mediated (or vasovagal) hypotension, delayed orthostatichypotension, postural orthostatic tachycardia syndrome, and idiopathic
    http://www.ahmf.org/98rowe.html
    Neurally Mediated Hypotension and CFS Peter C. Rowe, MD Dept of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA. Over the past half century, chronic fatigue has been described as a prominent symptom in a variety of syndromes of orthostatic intolerance. These overlapping syndromes have been variously termed neurally mediated (or vaso-vagal) hypotension, delayed orthostatic hypotension, postural orthostatic tachycardia syndrome, and idiopathic hypovolemia. Perhaps the first suggestion that these abnormalities were responsible for symptoms of what we now call chronic fatigue syndrome (CFS) was made in 1940 by MacLean and Allen. These authors described a syndrome of excessive elevation in heart rate with upright posture seemed identical to "effort syndrome, irritable heart or neurocirculatory asthenia" (JAMA 1940;115:2162-7). They recommended treatment with up to 14g of sodium per day and sleeping in a head-up position. Recent work in our center and others has emphasized a high prevalence of neurally mediated hypotension (NMH), and less commonly postural orthostatic tachycardia syndrome, in those with an established diagnosis of CFS. In a 1995 study of 23 adolescents and adults with CFS, we identified hypotension in response to a three stage 70 degree upright tilt table test in 96% of patients, versus 29% of healthy controls. During the first 45 minutes of upright tilt, 16 patients (or 70%) with CFS developed hypotension, while all controls maintained a normal blood pressure.Perhaps more importantly, all 23 with CFS but none of the controls developed orthostatic symptoms during this first stage of tilt testing, suggesting that orthostatic intolerance may be a defining feature of the illness.

    38. Directory :: Look.com
    postural orthostatic tachycardia syndrome (4) See Also. Postural OrthostaticTachycardia Syndrome Patient's report on causes, symptoms, and treatment.
    http://www.look.com/searchroute/directorysearch.asp?p=496593

    39. John Herr Psychologist Los Gatos Saratoga California Dr John Herr
    TITLE The postural orthostatic tachycardia syndrome a neurocardiogenicvariant identified during headup tilt table testing. AUTHOR
    http://www.clinicalpsychologist.com/clinicalpsychologist/Collected Abstracts/Vas
    National Library of Medicine: IGM Full Record Screen
    TITLE: The postural orthostatic tachycardia syndrome: a neurocardiogenic variant identified during head-up tilt table testing. AUTHOR: Grubb BP; Kosinski DJ; Boehm K; Kip K AUTHOR AFFILIATION: Department of Medicine, Medical College of Ohio, Toledo 43699, USA. SOURCE: Pacing Clin Electrophysiol 1997 Sep;20(9 Pt 1):2205-12 NLM CIT. ID: ABSTRACT: MAIN MESH SUBJECTS: Autonomic Nervous System Diseases/*DIAGNOSIS/DRUG THERAPY
    Syncope, Vasovagal/*DIAGNOSIS/DRUG THERAPY
    Tachycardia/*DIAGNOSIS/DRUG THERAPY ADDITIONAL MESH SUBJECTS: Adult
    Atenolol/THERAPEUTIC USE
    Erythropoietin, Recombinant/THERAPEUTIC USE
    Female
    Fludrocortisone/THERAPEUTIC USE
    Human
    Male
    Posture/PHYSIOLOGY Serotonin Uptake Inhibitors/THERAPEUTIC USE Tilt-Table Test PUBLICATION TYPES: JOURNAL ARTICLE LANGUAGE: Eng REGISTRY NUMBERS: (Erythropoietin, Recombinant)

    40. WebGuest - Open Directory : Health : Conditions And Diseases : Neurological Diso
    Top Health Conditions and Diseases Neurological Disorders Dysautonomiapostural orthostatic tachycardia syndrome (4). See also
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