The postural orthostatic tachycardia syndrome: A potentially treatable cause of chronic fatigue, exercise intolerance, and cognitive impairment in adolescents
The postural orthostatic tachycardia syndrome: A potentially treatable cause of chronic fatigue, exercise intolerance, and cognitive impairment in adolescents
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DOI：
10.1111/j.1540-8159.2000.tb06760.x
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发表时间：
2000-03-01
影响因子：
1.8
通讯作者：
Kip, K
中科院分区：
文献类型：
--
作者：
Karas, B;Grubb, BP;Kip, K
直立倾斜试验已成为一种公认的方法，以衡量一个人的体质介导的低血压和心动过缓严重到足以导致坦率晕厥的时期。与此同时，越来越明显的是，血压的不太明显的福尔斯下降，虽然不足以导致意识丧失，但可能会引起类似晕厥、眩晕和头晕的症状。我们描述了一个亚组的青少年，有一个轻微的农场自主神经功能障碍，表现出致残症状，如姿势性心动过速和心悸，极度疲劳，头晕，运动不耐症，认知功能障碍。在70度角的基线倾斜试验期间，这些患者在直立前10分钟内心率增加≥ 30次/min（或最大心率≥ 120次/min）（与严重低血压无关），这再现了其临床症状复合体。在成人人群中也有类似的观察结果，并被称为体位性直立性心动过速综合征（POTS）。我们报告POTS也可能发生在青少年中，是一种轻度的、潜在的可治疗的自主神经功能障碍，在直立倾斜试验中很容易发现。
Head upright tilt table testing has become an accepted method to measure an individual's predisposition to autonomically mediated periods of hypotension and bradycardia severe enough to cause frank syncope. At the same time if has become increasingly apparent that less profound falls in blood pressure, while not sufficient to result in loss of consciousness, may cause symptoms such as near syncope, vertigo, and dizziness. We describe a subgroup of adolescents that have a mild farm of autonomic dysfunction that exhibit disabling symptoms such as postural tachycardia and palpitations, extreme fatigue, lightheadedness, exercise intolerance, and cognitive impairment. During baseline tilt table testing at a 70 degrees angle, these patients demonstrated a heart rate increase of greater than or equal to 30 beats/min (or a maximum heart rate of greater than or equal to 120 beats/min) within the first 10 minutes upright (not associated with profound hypotension), which reproduced their clinical symptom complex. Similar observations have been made in the adult population and has been termed the postural orthostatic tachycardia syndrome (POTS). We report that POTS may also occur in adolescents and represents a mild, potentially treatable form of autonomic dysfunction that can be readily identified during head upright tilt table testing.