Full-text resources of PSJD and other databases are now available in the new Library of Science.
Visit https://bibliotekanauki.pl


Preferences help
enabled [disable] Abstract
Number of results


2008 | 3 | 3 | 361-364

Article title

Treatment questions in POTS with hypertension and syncope


Title variants

Languages of publication



A 27-year old man experienced recurrent syncope with prodromal palpitations and resultant injury. The features of these episodes suggested a potentially neurally-mediated mechanism. Head-up tilt test revealed the postural orthostatic tachycardia syndrome (POTS). Within the first minutes of upright posture during the total head-up tilt testing, a heart rate increase of >30 beats/min and to a maximum of 150 beats/min was documented in the patient. At the end of passive tilting, the patient lost consciousness in the absence of hypotension while in sinus rhythm of 140 bpm. The 12-lead ECG and electrophysiological study showed no abnormalities. The patient received a beta-adrenergic blocker, a selective central imidazoline receptor agonist and psychiatric therapy, resulting in only a short-term improvement.












Physical description


1 - 9 - 2008
10 - 7 - 2008


  • Department of Cardiology, Chair of Cardiology and Cardiac Surgery, Medical University of Lodz, 91-425, Lodz, Poland
  • Department of Cardiology, Chair of Cardiology and Cardiac Surgery, Medical University of Lodz, 91-425, Lodz, Poland


  • [1] Grubb B.P., Kosinski D.J., Boehm K., Kip K., The postural orthostatic tachycardia syndrome: a neurocardiogenic variant identified during head-up tilt table testing, Pacing Clin. Electrophysiol., 1997, 20, 2205–2212 http://dx.doi.org/10.1111/j.1540-8159.1997.tb04238.x[Crossref]
  • [2] Jauregui-Renaud K., Hermosillo J.A.G., Jardon J.L., Marquez M.F., Kostine A., Silva M.A., et al., Cerebral blood flow during supine rest and the first minute of head-up tilt in patients with orthostatic intolerance, Europace, 2005, 7, 460–464 http://dx.doi.org/10.1016/j.eupc.2005.04.004[Crossref]
  • [3] Goldstein D.S., Eldadah B., Holmes C., Pechnik S., Moak J., Sharabi Y., Neurocirculatory abnormalities in chronic orthostatic intolerance, Circulation, 2005, 111, 839–845 http://dx.doi.org/10.1161/01.CIR.0000155613.20376.CA[Crossref]
  • [4] Streeten D.H.P., Anderson G.H. Jr, Richardson R., Thomas F.D., Abnormal orthostatic changes in blood pressure and heart rate in subjects with intact sympathetic nervous function: evidence for excessive venous pooling, J. Lab. Clin. Med., 1988, 111, 326–335
  • [5] Jacob G., Shannon J., Costa F., Furlan R., Biaggioni I., Mosqueda-Garcia R., et al., Abnormal norepinephrine clearance and adrenergic receptor sensitivity in idiopathic orthostatic intolerance, Circulation, 1999, 98, 2154–2159
  • [6] Shannon J.R., Flattem N.L., Jordan J., Jacob G., Black B.K., Biaggioniet I., al., Orthostatic intolerance and tachycardia associated with norepinephrine transporter deficiency, N. Engl. J. Med., 2000, 342, 541–549 http://dx.doi.org/10.1056/NEJM200002243420803[Crossref]
  • [7] Goldstein D.S., Holmes C., Frank S.M., Dendi R., Cannon R.O. 3rd, Sharabi Y., et al., Cardiac sympathetic dysautonomia in chronic orthostatic intolerance syndromes, Circulation, 2002, 106, 2358–2365 http://dx.doi.org/10.1161/01.CIR.0000036015.54619.B6[Crossref]
  • [8] Grubb B.P., The postural tachycardia syndrome: etiology, diagnosis and treatment, In: Raviele A. (ed), Cardiac arrhythmias 2001, Springer Verlag, Milan Italia, 2002.
  • [9] Shibao C., Arzubiaga C., Roberts L.J. 2nd, Raj S., Black B., Harris P., et al., Hyperadrenergic postural tachycardia syndrome in mast cell activation disorders, Hypertension, 2005, 45, 385–390 http://dx.doi.org/10.1161/01.HYP.0000158259.68614.40[Crossref]
  • [10] Ewan V., Norton M., Newton J.L., Symptom improvement in postural orthostatic tachycardia syndrome with the ninus node blocker ivabradine, Europace, 2007, 9, 1202 http://dx.doi.org/10.1093/europace/eum235[Crossref][WoS]
  • [11] Lelonek M., Goch J.H., The role of moxonidine in treatment of vasovagal patients with essential hypertension, Arterial Hypertension, 2005, 9, 4, 276–284, (in Polish)
  • [12] Ernsberger P., Damon T.H., Graff L.M., Schafer S.G., Christen M.O., Moxonidine, a centrally acting antihypertensive agent, is a selective for I1-imidazoline sites, J. Pharmacol. Exp. Ther., 1993, 264, 172–182
  • [13] Benrud-Larson L.M., Dewar M.S., Sandroni P., Rummans T.A., Haythornthwaite J.A., Low P.A., Quality of life in patients with postural tachycardia syndrome, Mayo Clin Proc, 2002, 77, 531–537 http://dx.doi.org/10.4065/77.6.531[Crossref]
  • [14] Grubb B.P., Kanjwal M.Y., Kosinski D.J., The postural orthostatic tachycardia syndrome: current concepts in pathophysiology, diagnosis and management, J. Intervent. Cardiac Electrophysiol., 2001, 5, 9–16 http://dx.doi.org/10.1023/A:1009845521949[Crossref]

Document Type

Publication order reference


YADDA identifier

JavaScript is turned off in your web browser. Turn it on to take full advantage of this site, then refresh the page.