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Cardiol J. 2011;18(5):527-31.

Clinical presentation and management of patients with hyperadrenergic postural orthostatic tachycardia syndrome. A single center experience.

Kanjwal K, Saeed B, Karabin B, Kanjwal Y, Grubb BP.

Abstract

Background: We present our single center experience of 27 patients of hyperadrenergic postural orthostatic tachycardia syndrome (POTS). Methods: In a retrospective analysis, we reviewed the charts of 300 POTS patients being followed at our autonomic center from 2003 to 2010, and found 27 patients eligible for inclusion in this study. POTS was defined as symptoms of orthostatic intolerance (of greater than six months' duration) accompanied by a heart rate increase of at least 30 bpm (or a rate that exceeds 120 bpm) that occurs in the first 10 min of upright posture or head up tilt test (HUTT) occurring in the absence of other chronic debilitating disorders. Patients were diagnosed as having the hyperadrenergic form based on an increase in their systolic blood pressure of ≥ 10 mm Hg during the HUTT (2) with concomitant tachycardia or their serum catecholamine levels (serum norepinephnrine level ≥ 600 pg/mL) upon standing. Results: Twenty seven patients, aged 39 ± 11 years, 24, (89%) of them female and 22 (82%) Caucasian were included in this study. Most of these patients were refractory to most of the first and second line treatments, and all were on multiple combinations of medications. Conclusions: Hyperadrenergic POTS should be identified and differentiated from neuropathic POTS. These patients are usually difficult to treat and there are no standardized treatment protocols known at this time for patients with hyperadrenergic POTS. (Cardiol J 2011; 18, 5: 527-531). PMID: 21947988

Posted

I was involved with a study in the nursing home related to falls and cognitive decline. Guess what they found out. No matter what steps were taken by staff to try to prevent falling, once a person reaches a certain level of cognitive decline-THEY FALL-no matter what you do.

I had been working in long term care probably for 15 years by that point and when she told me I said-so they've finally figured it out.

I was so frustrated with staff getting blamed.

So I know exactly where you're coming from Sue.

When I first logged on I was greeted by a person local from the get to know you program.

She asked about my symptoms said I sounded hyperadrenergic and warned for many meds don't help with that type. Sounds like she was right on the money at least the same meds aren't consistent for all is the way I would describe it. It really requires an individualized treatment plan for sure

Posted

DUH!!! You don't say! Ugh! Why don't they just listen to us. They think we're nuts when we tell them that what they are telling us to do is making us sicker and wonder why. Us with HyperPOTS have to do almost the opposite of what a person with regular POTS does. At least we have it figured out - hopefully the doctors will soon get it figured out too.

Issie

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