BookNicholas Gall, Lesley Kavi, Melvin D. Lobo, editors.
Summary: This book describes the varying clinical manifestations of postural tachycardia syndrome (PoTS) and provides a robust yet practical set of clinical tools for those managing patients suffering with this syndrome. Guidance is provided by a range of disciplines relevant to PoTS including general and specialist assessments, associated conditions, diagnostic considerations, therapy and service models. Postural Tachycardia Syndrome: A Concise and Practical Guide to Management and Associated Conditions presents the scientific background and practical information for the busy medical professional, illustrating key features with care-based materials to help them manage this condition, which can be a challenge for patients and clinicians alike.
Contents:
Intro
Foreword
Contents
POTS, An Introduction
Introduction
References
Historical Background
References
Clinical Presentation
References
Specialty Assessment
Diagnostic Criteria for Postural Tachycardia Syndrome: Consideration of the Clinical Features Differentiating PoTS from Other Disorders of Orthostatic Intolerance
Abbreviations
Background
Diagnostic Criteria
Clinical Evaluation of a Patient with Suspected PoTS
Orthostatic Tachycardia Must Occur Within 10 minutes
Symptoms of Orthostatic Intolerance and Symptoms Independent of Orthostasis PoTS is a Chronic Disorder
Other Causes of Tachycardia
Dehydration and Acute Blood Volume Loss
Deconditioning
Medications
Other Medical Conditions
Diurnal Variability in Orthostatic Tachycardia
Common Misconceptions Regarding the Diagnosis of PoTS
Tilt Table Testing
Specialist Referral
Syncope
Distinguishing PoTS from Other Types of Orthostatic Intolerance
Orthostatic Tachycardia Without Orthostatic Symptoms
Orthostatic Symptoms Without Orthostatic Tachycardia
Inappropriate Sinus Tachycardia (IST) Orthostatic Hypotension (OH) and Initial Orthostatic Hypotension (IOH)
Diagnosing PoTS in the Pediatric Patient
Conclusions
References
Pathophysiology and Classification of PoTS
Abbreviations
Introduction
Partial Sympathetic Neuropathy
Chronic Hypovolemia and Renin-Angiotensin-Aldosterone System
Hyperadrenergic State
Hyperadrenergic State: Norepinephrine Transporter Deficiency
Immune-Mediated
Mast Cell Activation
Deconditioning
Impaired Cerebral Autoregulation
Conclusion
References Cardiological Considerations: Tests to Consider, Are They Useful and What Do They Show?
Echocardiography
Holter Electrocardiography
Cardiopulmonary Exercise Testing
References
Neurological Investigations
Neurological Investigations in PoTS
An Approach to Neurological Investigations in PoTS
Neurological Investigations Within Primary Care
Neurological Investigations Within Secondary/Tertiary Care
In Summary
References
The Active Stand and Tilt Tests
Abbreviations
Assessment of Orthostatic Tachycardia
General Considerations Advantages and Disadvantages of Active Stand Testing and the Head up Tilt Test
Conclusion
References
Additional Autonomic Tests
Introduction
Autonomic Target-Organs Neurophysiological Tests (ATONT)
Definition of Autonomic Failure
Assessment of Central Parasympathetic Function
Resting Supine Cardiac Vagal Tone (CVT)
Respiratory Gating of Cardiac Vagal Tone (CVT) in Supine Position
Resting Supine Cardiac Sensitivity to Baroreflex (CSB)
Assessment of Central Baroreflex Gain
Assessment of Peripheral Baroreflex Function