Department of Internal Medicine, Azeezia Medical College, Kollam, Kerala, India.
University of Santo Tomas Faculty of Medicine and Surgery, Manila, Philippines.
Curr Probl Cardiol. 2022 Dec;47(12):101384. doi: 10.1016/j.cpcardiol.2022.101384. Epub 2022 Aug 31.
Postural Orthostatic Tachycardia Syndrome (POTS) is a variant of autonomic cardiovascular disorder characterized by an excessive increase in heart rate upon standing associated with light-headedness, headaches, chest pain, shortness of breath, and brain fog. The etiology of POTS is largely unknown and often debilitating. The 3 major hypotheses about the pathophysiology of POTS are autoimmunity, abnormally increased sympathetic activity, and sympathetic denervation leading to central hypovolemia and reflex tachycardia. Given its heterogeneous nature, it is crucial to understand each component of POTS with more emphasis on incorporating a multidisciplinary approach to control the symptoms. Future works should focus on better understanding the POTS pathophysiology and designing randomized controlled trials for implementing effective therapy. In this review, we outline the extent of the problem, studies and resources needed to address the issue, and the diagnostic and therapeutic updates on POTS.
体位性心动过速综合征(POTS)是一种自主心血管功能障碍的变异,其特征是站立时心率过度增加,伴有头晕、头痛、胸痛、呼吸急促和脑雾。POTS 的病因在很大程度上尚不清楚,且常使人虚弱。关于 POTS 病理生理学的 3 个主要假说为自身免疫、异常增加的交感神经活动和导致中枢低血容量和反射性心动过速的交感神经去神经支配。鉴于其异质性,了解 POTS 的各个组成部分至关重要,更要强调采用多学科方法来控制症状。未来的工作应侧重于更好地理解 POTS 的病理生理学,并设计随机对照试验以实施有效的治疗。在本综述中,我们概述了问题的严重程度、解决问题所需的研究和资源,以及 POTS 的诊断和治疗更新。