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Orthostatic intolerance and postural tachycardia syndrome: new insights into pathophysiology and treatment

Orthostatische Intoleranz und posturales Tachykardiesyndrom: neue Erkenntnisse zur Pathophysiologie und Behandlung

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Abstract

Orthostatic intolerance is characterized by symptoms of light-headedness or syncope that is provoked upon standing or in an upright posture. It is most commonly caused by postural orthostatic tachycardia syndrome (POTS) or orthostatic hypotension (OH). Its pathophysiology is complex and commonly involves abnormal autonomic nervous system regulation, autoimmunity, a hyperadrenergic state, and hypovolemia. This article reviews the pathophysiology underlying orthostatic intolerance, as well as the current treatment available.

Zusammenfassung

Orthostatische Intoleranz ist durch Symptome der Benommenheit oder Synkope charakterisiert, die durch Aufstehen oder aufrechtes Stehen provoziert werden. Ursache ist meist das posturale orthostatische Tachykardiesyndrom oder eine orthostatische Hypotonie. Die Pathophysiologie ist komplex und bezieht üblicherweise eine abnorme Regulation des autonomen Nervensystems, Autoimmunreaktionen, einen hyperadrenergen Zustand und Hypovolämie ein. In dieser Übersicht werden die Pathophysiologie, die der orthostatischen Intoleranz zugrunde liegt, und derzeit verfügbare Behandlungsmöglichkeiten zusammengefasst.

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Authors and Affiliations

  1. Cardiology, The Pennsylvania State Heart and Vascular Institute, Hershey, PA, USA

    Mohammed Ruzieh MD

  2. Division of Cardiovascular Medicine, The University of Toledo Medical Center, 3000 Arlington Ave., 43614, Toledo, OH, USA

    Blair P. Grubb MD FACC

Authors
  1. Mohammed Ruzieh MD
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  2. Blair P. Grubb MD FACC
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Correspondence to Blair P. Grubb MD FACC.

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Conflict of interest

M. Ruzieh and B.P. Grubb declare that they have no competing interests.

This article does not contain any studies with human participants or animals performed by any of the authors.

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Ruzieh, M., Grubb, B.P. Orthostatic intolerance and postural tachycardia syndrome: new insights into pathophysiology and treatment. Herzschr Elektrophys 29, 183–186 (2018). https://doi.org/10.1007/s00399-018-0563-1

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  • DOI: https://doi.org/10.1007/s00399-018-0563-1

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