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  1. 1 Open Medicine

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  1. 1 2008

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  1. 1 Goch J.

  2. 1 Lelonek M.

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Treatment questions in POTS with hypertension and syncope

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Lelonek M., Goch J.
Open Medicine
|
2008
|
vol. 3
|
issue 3
361-364
EN
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.
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