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Postural tachycardia syndrome with asystole on head-up tilt

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Abstract

Enhanced sympathetic activity causes an exaggerated heart rate response to standing in the postural tachycardia syndrome (POTS). All patients describe symptoms of orthostatic intolerance such as dizziness, blurred vision, shortness of breath, palpitations, tremulousness, chest discomfort, headache, lightheadedness and nausea, but only one third suffer loss of consciousness. We report four patients with POTS, who had long ventricular pauses (i.e. asystole) and syncope during head-up tilt test. This suggests that a subset of patients with POTS can have a surge in parasympathetic outflow that precedes vasovagal syncope.

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Authors and Affiliations

  1. Autonomic Laboratory, Neurological Institute, University Hospitals Case Medical Center, Cleveland, OH, USA

    Amer Alshekhlee MD, MSc, Meziane Guerch MD, Faisal Ridha, Kevin Mcneeley & Thomas C. Chelimsky MD

  2. Neurological Institute, University Hospitals Case Medical Center, Case Western Reserve University, 11100 Euclid Ave., Hanna House 5, Cleveland, OH, 44106, USA

    Amer Alshekhlee MD, MSc

Authors
  1. Amer Alshekhlee MD, MSc
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  2. Meziane Guerch MD
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  3. Faisal Ridha
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  4. Kevin Mcneeley
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  5. Thomas C. Chelimsky MD
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Corresponding author

Correspondence to Amer Alshekhlee MD, MSc.

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Disclosures: The authors have nothing to disclose.

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Alshekhlee, A., Guerch, M., Ridha, F. et al. Postural tachycardia syndrome with asystole on head-up tilt. Clin Auton Res 18, 36–39 (2008). https://doi.org/10.1007/s10286-007-0445-9

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  • DOI: https://doi.org/10.1007/s10286-007-0445-9

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