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Postural Orthostatic Tachycardia Syndrome: Prevalence, Pathophysiology, and Management

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Abstract

Postural orthostatic tachycardia syndrome (POTS) is a debilitating disease that predominantly affects young women. It is a multifactorial disorder that is characterized by severe tachycardia and orthostatic intolerance. Patients with POTS experience a variety of cardiac, neurological, and immunological symptoms that significantly reduce quality of life. In this review, a comprehensive framework is provided to aid in helping identify and treat patients with POTS. Given its heterogenous nature, it is crucial to understand each component of POTS in relation to one another instead of distinct parts. The framework highlights the overlap among the five main subtypes of POTS based on its pathophysiology (neuropathic, hypovolemic, primary hyperadrenergic, joint-hypermobility-related, and immune-related). Emphasis is placed on incorporating a multidisciplinary approach when treating patients with POTS, especially with a new focus towards immunotherapy. Although research has advanced our knowledge of POTS, there is still a critically unmet need to further our understanding and provide patients with the relief they need.

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Authors and Affiliations

  1. Division of Cardiovascular Medicine, University of California San Diego, 9300 Campus Point Drive MC 7411, La Jolla, CA, 92037, USA

    Adena Zadourian, Iwona Swiatkiewicz & Pam R. Taub

  2. Division of Rheumatology, Allergy, and Immunology, University of California San Diego, La Jolla, CA, USA

    Taylor A. Doherty

  3. Department of Cardiology and Internal Medicine, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland

    Iwona Swiatkiewicz

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  1. Adena Zadourian
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  2. Taylor A. Doherty
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Correspondence to Pam R. Taub.

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No funding was received for the preparation of this article.

Conflict of interest

Pam R. Taub has disclosed a potential conflict of interest as she has received a grant from Amgen to investigate the effect of Ivabradine in patients with POTS. Adena Zadourian, Taylor A. Doherty, and Iwona Swiatkiewicz have no conflicts of interest to disclose. This manuscript was prepared in Compliance with Ethical Standards.

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Zadourian, A., Doherty, T.A., Swiatkiewicz, I. et al. Postural Orthostatic Tachycardia Syndrome: Prevalence, Pathophysiology, and Management. Drugs 78, 983–994 (2018). https://doi.org/10.1007/s40265-018-0931-5

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