Orthostatic heart rate does not predict symptomatic burden in pediatric patients with chronic orthostatic intolerance.

Clinical Autonomic Research : Official Journal of the Clinical Autonomic Research Society
Jeffrey R BorisThomas Bernadzikowski

Abstract

Postural orthostatic tachycardia syndrome (POTS) in adults is defined as symptoms of chronic orthostatic intolerance (COI) and autonomic dysfunction (AD) with heart rate (HR) increase of 30 beats per minute (bpm), or HR > 120 bpm, during prolonged upright position. However, in adolescents, POTS is defined as symptoms of OI and AD with HR increase of ≥ 40 bpm, based on tilt table data. We assessed frequency of COI symptoms in pediatric patients versus HR criteria on prolonged standing to evaluate using criteria of increased HR of 30-39 bpm versus ≥ 40 bpm in our POTS Program. Patients with COI with symptoms for > 3 months plus HR increase of ≥ 30 bpm on 10 min stand aged ≤ 18 years at diagnosis were included. Patients were divided into two groups: those with HR increase of 30-39 bpm, and those with HR increase of ≥ 40 bpm or upright HR of > 120 bpm. A total of 28 symptoms described prior to diagnosis were evaluated using chi-square testing to assess for significant differences. Only insomnia was found to be significantly different between the two groups. The other 27 symptoms showed no significant difference as a function of HR. There are minimal statistically significant differences and no clinical differences between patients ...Continue Reading

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Citations

Jan 3, 2021·Clinical Autonomic Research : Official Journal of the Clinical Autonomic Research Society·Eduardo E Benarroch
Jan 4, 2021·Autonomic Neuroscience : Basic & Clinical·Jeffrey R Boris, Thomas Bernadzikowski
Nov 19, 2021·American Journal of Physical Medicine & Rehabilitation·Amanda K MorrowLaura A Malone

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