Case Report
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jul 16, 2015; 3(7): 655-660
Published online Jul 16, 2015. doi: 10.12998/wjcc.v3.i7.655
Reversible postural orthostatic tachycardia syndrome
Aza Abdulla, Thirumagal Rajeevan
Aza Abdulla, Department of Care of the Elderly, Princess Royal University Hospital, King’s College Hospital NHS Foundation Trust, Farnborough Common, Orpington, BR6 8ND Kent, United Kingdom
Thirumagal Rajeevan, Department of Care of the Elderly, St Peter’s Hospital, Chertsey, KT16 0PZ Surrey, United Kingdom
Author contributions: Abdulla A made the diagnosis, performed the test to confirm the diagnosis and finalised the writing; Rajeevan T performed literature search and preliminary writing.
Institutional review board statement: Not needed.
Informed consent statement: Patient involved in this case report provided informed written consent.
Conflict-of-interest statement: None.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Thirumagal Rajeevan, MBBS, MRCP, Department of Care of the Elderly, St Peter’s Hospital, Guildford Road, Chertsey, KT16 0PZ Surrey, United Kingdom. thiru.rajeevan@gmail.com
Telephone: +44-7967-624205
Received: July 12, 2014
Peer-review started: July 12, 2014
First decision: August 14, 2014
Revised: March 3, 2015
Accepted: April 10, 2015
Article in press: April 14, 2015
Published online: July 16, 2015
Abstract

Postural orthostatic tachycardia syndrome (POTS) is a relatively rare syndrome recognised since 1940. It is a heterogenous condition with orthostatic intolerance due to dysautonomia and is characterised by rise in heart rate above 30 bpm from base line or to more than 120 bpm within 5-10 min of standing with or without change in blood pressure which returns to base line on resuming supine position. This condition present with various disabling symptoms such as light headedness, near syncope, fatigue, nausea, vomiting, tremor, palpitations and mental clouding, etc. However there are no identifiable signs on clinical examination and patients are often diagnosed to have anxiety disorder. The condition predominantly affects young female between the ages of 15-50 but is rarely described in older people. We describe an older patient who developed POTS which recovered over 12 mo. Recognising this condition is important as there are treatment options available to alleviate the disabling symptoms.

Keywords: Postural, Orthostatic, Tachycardia, Dysautonomia, Hypotension, Postural tachycardia syndrome, Older person

Core tip: This is a short report and literature review on postural orthostatic tachycardia syndrome (POTS). POTS commonly affects younger patients and is rarely reversible. Here we describe an older patient who presented with disabling POTS which was reversed. Although rare, it is now being recognised in older people and increasing awareness among geriatricians is important as early diagnosis and treatment may alleviate the disabling symptoms. Reviewing the literature we argue whether hypotension should be considered as a feature of POTS.