Abstract Objective To describe the postural orthostatic tachycardia syndrome (POTS), including clinical presentation, pathophysiology, diagnostic methods, and current management models. [doi.org]

Prognosis and Impact of POTS At present, only limited data are available on the prognosis of patients with POTS. [circ.ahajournals.org]

• Plethora

  The prevalence in the UK is unknown 4 but probably under-estimated due to overlap with other pathologies such as chronic fatigue, post-viral syndromes, and limited availability of knowledgeable healthcare personnel. 7 NON-SPECIFIC SYMPTOMS A plethora [doi.org]

• Acrocyanosis

  Look for acrocyanosis (puffy, bluish discolouration of lower legs which occurs in almost 50% of patients and is thought to be due to venous pooling). 1 A sustained increase in heart rate of >30 bpm suggests PoTS and referral should be considered. [doi.org]

  The patient has apparent acrocyanosis, koilonychia, >2 second capillary refill, a resting tremor affecting both hands, and patchy loss of eyelashes on both upper and lower eyelids bilaterally. [jcadonline.com]

  Dependent acrocyanosis in postural tachycardia syndrome (POTS). A striking physical feature in POTS is the gross change in dependent skin color that can occur with standing. [web.archive.org]

• Hyperextensible Joints

  Patients are characterized by skin hyperextensibility, joint hypermobility, and fragile connective tissue [ 34 •]. [doi.org]

• Sweating

  […] could alternate between sweating too much and not sweating enough digestive difficulties, such as a loss of appetite, bloating, diarrhea, constipation, or difficulty swallowing urinary problems, such as difficulty starting urination, incontinence, and [healthline.com]

  "Regional variations in transepidermal water loss, eccrine sweat gland density, sweat secretion rates and electrolyte composition in resting and exercising humans". Extreme Physiology & Medicine. 2 (1): 4. doi:10.1186/2046-7648-2-4. PMC 3710196. [en.wikipedia.org]

  Causes include vomiting, excessive sweating, diarrhea, burns, diuretic use, and kidney failure. Clinical features include diminished skin turgor, dry mucous membranes, tachycardia, and orthostatic hypotension. Diagnosis is clinical. [msdmanuals.com]

  Manifestations include impairments of vegetative functions including the maintenance of blood pressure; heart rate; pupil function; sweating; reproductive and urinary physiology; and digestion Your autonomic nervous system is the part of your nervous [icd9data.com]

  Severely deconditioned patients were similar to non-deconditioned patients, except for 24 h urine volume (1,555 vs. 2,417 ml), sweat loss on thermoregulatory sweat test (1.5 vs. 0.5 %), and few respiratory parameters during exercise, which are likely [ncbi.nlm.nih.gov]

• Anhidrosis

  The evidence in support of this is as follows: Distal anhidrosis of the legs is commonly found on thermoregulatory sweat testing and quantitative sudomotor axon reflex testing (up to 50% of POTS patients). 4, 10 Ganglionic acetylcholine receptor antibody [web.archive.org]

  The clinical picture is dominated by orthostatic hypotension, widespread anhidrosis, dry mouth, dry eyes, sexual dysfunction, urinary retention, impaired pupillary responses, reduced heart rate variability and gastrointestinal symptoms ranging from gastroparesis [stoppotsvirginia.blogspot.com]

• Vertigo

  Pappas, Autonomic related vertigo, The Laryngoscope, 113, 10, (1658-1671), (2010). Gonzalo Barón-Esquivias, Aurelio Cayuela, Alonso Pedrote, Soledad Cabezón, Juan E. [dx.doi.org]

  Acute/chronic otitis media Acoustic neuroma Barotrauma Cholesteatoma Dysfunction of eustachian tube Foreign body Hearing impairment Hematoma of external ear Labyrinthitis Mastoiditis Meniere disease Otitis externa Tinnitus Tympanic membrane perforation Vertigo [nccpa.net]

  People often refer to dizziness as vertigo, unsteadiness, or lightheadedness. [medicinenet.com]

  Low blood pressure of any cause may promote the following: [4] lightheadedness, sometimes called pre-syncope (pre-fainting) dizziness (but not vertigo, which is also called dizziness) [5] exercise intolerance extreme fatigue syncope (fainting) Excessive [dysautonomiaconnection.org]

  Low blood pressure of any kind may promote the following: [3] lightheadedness, sometimes called pre-syncope (pre-fainting) dizziness (but not vertigo, which is also called dizziness) [4] exercise intolerance extreme fatigue syncope (fainting) Excessive [psychology.wikia.com]

A couple of years prior to the above, I had a cardiac workup after having premature ventricular contractions (PVCs). One thing they noticed right away is my blood levels of magnesium were low. [forum.marksdailyapple.com]

Because her recent preoperative cardiac workup had been negative, no further evaluation was conducted. Her antihypertensive and insulin therapies were discontinued, and her primary care provider was contacted to maintain close follow up. [bariatrictimes.com]

• Sinus Arrhythmia

  POTS patients often have preserved vagal function (as reflected by their sinus arrhythmia ratio in response to deep breathing) and a vigorous pressor response to the Valsalva maneuver, with an exaggerated BP recovery and overshoot both before and after [web.archive.org]

  These patients often have preserved vagal function as reflected by their sinus arrhythmia ratio in response to deep breathing. [hopealways.wordpress.com]

but many suggested treatments have a poor evidence base. [doi.org]

Gene expression data in adipose tissue biopsies before sibutramine treatment, after 5 d of sibutramine treatment, and after completion of chronic sibutramine treatment. [academic.oup.com]

Treatment Current treatment options for POTS include a multitude of marginally effective medicinal modalities and behavioral techniques. One must be able to recognize the subtype of POTS and individualize treatment. [jcadonline.com]

Prognosis and Impact of POTS At present, only limited data are available on the prognosis of patients with POTS. [web.archive.org]

Treatment and prognosis The vast majority of patients are managed with simple analgesia and oral antibiotics. [radiopaedia.org]

Acute epididymitis revisited: impact of molecular diagnostics on etiology and contemporary guideline recommendations. Eur Urol. 2014 Dec 23 [Epub ahead of print]. 11. Siegel A, Snyder H, Duckett JW. [uspharmacist.com]

• Other rare viral etiologies include coxsackievirus, infectious mononucleosis,varicella, and echovirus. • Bacterial causes usually spread from an associated epididymitis in sexually active men or men with BPH: – bacteria include Neisseria gonorrhoeae [slideshare.net]

Etiology Osteopetrosis is caused by failure of osteoclast development or function, and mutations in at least ten genes have been identified as causative in humans, accounting for 70% of all cases. [orpha.net]

Biochemical classification Finally, one should attempt to determine the etiology of the anemia as specifically as possible. [web2.airmail.net]

The underlying pathophysiology is thought to involve activation of the sympathetic nervous system, but the actual etiology is poorly understood. [nature.com]

Summary Epidemiology The overall prevalence and incidence of these conditions is difficult to estimate but autosomal recessive malignant osteopetrosis (ARO; see this term) has an incidence of 1/ 250,000 births, and autosomal dominant osteopetrosis (ADO [orpha.net]

Conclusions: Abbreviated tilt table testing misses a substantial proportion of those ultimately diagnosed with POTS during a 10-minute tilt table test, and should be abandoned for the clinical diagnosis and in epidemiologic studies designed to estimate [hetalternatief.org]

Jacob G and Robertson D (1995) Orthostatic hypotension: epidemiology, pathophysiology and management. Curr Opin Nephrol Hypertens 4 : 452–454 5. Robertson D and Davis TL (1995) Recent advances in the treatment of orthostatic hypotension. [nature.com]

International journal of epidemiology, 38(4), 963-970. Van Drongelen, A., Boot, C. R., Merkus, S. L., Smid, T., & Van Der Beek, A. J. (2011). The effects of shift work on body weight change—a systematic review of longitudinal studies. [edinstitute.org]

6 Differences in muscle sympathetic nerve discharge characteristics, in the setting of sympathetic fibre loss associated with POTS, may contribute to the predisposition to and greater prevalence of POTS in female individuals. 7 There are no accurate epidemiological [web.archive.org]

Nonpharmacologic and pharmacologic treatment methods are available to improve the underlying pathophysiology of the disorder. Laryngoscope, 127:1195–1198, 2017 [doi.org]

It can be divided into a number of overlapping pathophysiological models as follows. Neuropathic This is thought to be associated with partial dysautonomia. [web.archive.org]

Pathophysiology of POTS Tachycardia and asthenia on standing is a final common pathway of many pathophysiological processes. POTS is therefore best viewed as a syndrome rather than a disease. [hopealways.wordpress.com]

There are a number of possible dermatological manifestations of postural orthostatic tachycardia syndrome easily explained by its recently discovered pathophysiology. [jcadonline.com]

CDC, US Centers for Disease Control and Prevention CFS, chronic fatigue syndrome ME, myalgic encephalomyelitis NMH, neurally mediated hypotension NRI, norepinephrine reuptake inhibitor POTS, postural orthostatic tachycardia syndrome SSRI, selective serotonin [doi.org]

The drug pyridostigmine is often quite helpful in preventing supine OH without worsening SH. In some SH/OH patients the swings in blood pressure are so extreme that midodrine or droxidopa is administered when upright to prevent OH. [innovationsincrm.com]

Hyperadrenergic POTS treatment is targeted towards preventing release of these transmitters or prevention of their action. [myheart.net]

Beta blocker medications such as metoprolol (Inderal) block the beta-adrenergic receptors in the body, preventing the heart from speeding up, preventing the heart from contracting as forcefully, and dilating blood vessels. [medicinenet.com]