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Europace 2009 11(1):18-25; doi:10.1093/europace/eun324
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2009. For permissions please email: journals.permissions@oxfordjournals.org

REVIEW

A review of postural orthostatic tachycardia syndrome

Sheila Carew, Margaret O. Connor, John Cooke, Richard Conway, Christine Sheehy, Aine Costelloe and Declan Lyons*

Blood Pressure Unit, Mid Western Regional Hospital, Limerick, Ireland

A 21-year-old female reports an 18-month history of light-headedness on standing. This is often associated with palpitations and a feeling of intense anxiety. She has had two black-outs in the past 12 months. She is not taking any regular medications. Her supine blood pressure was 126/84 mmHg with a heart rate of 76 bpm, and her upright blood pressure was 122/80 mmHg with a heart rate of 114 bpm. A full system examination was otherwise normal. She had a 12-lead electrocardiogram performed which was unremarkable. She was referred for head-up tilt testing. She was symptomatic during the test and lost consciousness at 16 min. Figure 1 summarizes her blood pressure and heart rate response to tilting. A diagnosis of postural orthostatic tachycardia syndrome with overlapping vasovagal syncope was made.

Key Words: Tilt table testing, Clinical features, Pathophysiology, Treatment, Postural orthostatic tachycardia syndrome

* Corresponding author. Tel: +353 61482623, E-mail address: sheila.carew{at}hse.ie

Manuscript submitted 4 July 2008. Accepted after revision 4 November 2008.


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S. Carew, J. Cooke, M. O'Connor, T. Donnelly, A. Costelloe, C. Sheehy, and D. Lyons
What is the optimal duration of tilt testing for the assessment of patients with suspected postural tachycardia syndrome?
Europace, May 1, 2009; 11(5): 635 - 637.
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