O-AD003. Postural Orthostatic Tachycardia Syndrome (POTS): A case series from India

Abstract

Introduction . POTS (Postural Orthostatic Tachycardia Syndrome) is defined as the presence of chronic symptoms of orthostatic intolerance (≥6 months) accompanied by an increased heart rate (HR) ≥30 bpm within 10 minutes of assuming an upright posture in the absence of orthostatic hypotension. It is diagnosed by tilt table testing where the heart rate at base line and on standing is recorded. The incidence and presenting complaints of this disease has not been studied in the Indian subcontinent. Methods . This is a retrospective study where we looked into the data of patients with diagnosis of POTS over a period of 3 years (August 2014–August 2017). We are describing the baseline demographics, clinical presentations, investigations, treatment and follow up of these patients. POTS was diagnosed based on inclusion criteria with a tilt table. Heart rate was recorded in supine position and then in upright position. Continuous heart rate and BP recording was done every minute for 10 minutes and if patient had symptoms it was noted. Results . During the study period from August 2015–August 2017 we had 42 patients with POTS. This was 7.7% of all patients who had positive tilt table testing during this period. The cohort had 24 males and 18 females. Commonest symptoms were postural giddiness in 18 patients, palpitation on standing and walking in 13 patients and postural syncope in 12 patients. 13 patients had improvement with excess fluid intake, while 29 patients required drug therapy. Conclusion . This is the only series of POTS from India. POTS is not a rare cause of orthostatic intolerance as previously reported. High index of suspicion can help in early identification and treatment of this syndrome.