Review of postural orthostatic tachycardia syndrome: a predominantly female condition

Abstract

Postural orthostatic tachycardia syndrome is a debilitating and underdiagnosed condition, affecting five times as many women of childbearing age as it does men. The true prevalence is difficult to estimate, with charities reporting up to potentially 3 million people with the condition in the United States. There is a lack of awareness and knowledge regarding how to manage people with postural orthostatic tachycardia syndrome. This results in a difficult journey to diagnosis. The average length of time to diagnosis from symptom onset is 4 years in the UK with dismissals of symptoms and misdiagnosis being common experiences. The largest online survey by an American charity found that 75% of women were misdiagnosed with anxiety compared with 25% of men. This article aims to raise awareness of postural orthostatic tachycardia syndrome, its underlying pathophysiology, diagnosis and the impact on quality of life, as well as the management and socioeconomic impact of the condition. Cardiac nurses who meet people with postural orthostatic tachycardia syndrome can improve the patient experience. Being aware of the condition, validating the experiences of these young, predominantly female, patients to rebuild trust, and providing support can make a huge difference.