Pooling in Chronic Orthostatic Intolerance Arterial Vasoconstrictive but not Venous Compliance Defects
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The findings suggest that pooling in POTS is due to blunted arterial vasoconstriction, which produces passive redistribution of blood within peripheral venous capacitance beds.Abstract:
Background— Orthostatic intolerance is characterized by postural tachycardia syndrome (POTS) with exaggerated tachycardia, orthostatic symptoms, and “pooling” (which comprises acrocyanosis and dependent edema when upright). My colleagues and I tested the hypothesis that pooling results from increased venous compliance in POTS patients. Methods and Results— Fifteen patients aged 13 to 19 years were compared with 11 healthy, age-matched controls. The POTS group was divided into patients with high venous pressure (Pv>20 mm Hg) and normal Pv on the basis of resting supine Pv obtained in previous work. Subjects were studied using strain gauge plethysmography to measure blood flow, Pv, and the venous compliance volume-pressure relation while supine and during incremental head-up tilt testing at −10°, 0°, 20°, and 35°. Volume-pressure relations of controls and POTS patients with normal Pv and high Pv were not different and were unchanged by orthostasis. Supine leg peripheral resistance was greater than control r...read more
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Journal ArticleDOI
ACC/AHA/ESC Guidelines for the Management of Patients with Supraventricular Arrhythmias - Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Develop Guidelines for the Management of Patients with Supraventricular Arrhythmias)
Carina Blomström-Lundqvist,Melvin M. Scheinman,Etienne Aliot,Joseph S. Alpert,Hugh Calkins,A. John Camm,W. Barton Campbell,David E. Haines,Karl H. Kuck,Bruce B. Lerman,D. Douglas Miller,Charlie Willard Shaeffer,William G. Stevenson,Gordon F. Tomaselli,Elliott M. Antman,Sidney C. Smith,David P. Faxon,Valentin Fuster,Raymond J. Gibbons,Gabriel Gregoratos,Loren F. Hiratzka,Sharon A. Hunt,Alice K. Jacobs,Richard O. Russell,Silvia G. Priori,Jean Jacques Blanc,A Budaj,Enrique Fernandez Burgos,Martin R. Cowie,Jaap W. Deckers,Maria Angeles Alonso Garcia,Werner Klein,John Lekakis,Bertil Lindahl,Gianfranco Mazzotta,João Morais,Ali Oto,Otto A. Smiseth,Hans Joachim Trappe +38 more
TL;DR: New guidelines for the management of patients with supraventricular arrhythmias are introduced and recommended for use in combination with standard clinical practice.
ACC/AHA/ESC guidelines for the management of patients with supraventricular arrhythmiasM — executive summary A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Develop Guidelines for the Management of Patients With Supraventricular Arrhythmias)
Joseph S. Alpert,Elliott M. Antman,Sidney C. Smith,David P. Faxon,Valentin Fuster,Raymond J. Gibbons,Gabriel Gregoratos,Loren F. Hiratzka,Sharon A. Hunt,Alice K. Jacobs,Richard O. Russell +10 more
TL;DR: Blomstrom-Lundqvist et al. as discussed by the authors proposed the ESC guidelines for the management of patients with supraventricular arrhythmias, which are based on the guidelines of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines.
Journal ArticleDOI
ACC/AHA/ESC guidelines for the management of patients with supraventricular arrhythmias∗—executive summary: a report of the American college of cardiology/American heart association task force on practice guidelines and the European society of cardiology committee for practice guidelines (writing committee to develop guidelines for the management of patients with supraventricular arrhythmias) Developed in Collaboration with NASPE-Heart Rhythm Society☆
TL;DR: In this paper, the authors present a set of guidelines for the diagnosis and management of supraventricular arrhythmias, which are intended to assist physicians in clinical decision-making by describing a range of generally acceptable approaches.
Journal ArticleDOI
A textbook of physiology
Journal ArticleDOI
Postural Orthostatic Tachycardia Syndrome: The Mayo Clinic Experience
Mark J. Thieben,Paola Sandroni,David M. Sletten,Lisa M. Benrud-Larson,Robert D. Fealey,Steven Vernino,Steven Vernino,Vanda A. Lennon,Win Kuang Shen,Phillip A. Low +9 more
TL;DR: A neuropathic basis for at least half the cases of POTS is suggested and that a substantial percentage of cases may be autoimmune.
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