ABSTRACT
Background: Patients with postural orthostatic tachycardia syndrome (POTS) report dizziness, lightheadedness, weakness, blurred vision, and fatigue upon standing. The diagnosis of the syndrome is made when an orthostatic intolerance and tachycardia appear in the standing position. Aim: To report 15 patients with POTS. Material and Methods: Review of Tilt test reports in a period of 15 years. Those reports in which orthostatic postural tachycardia and symptoms compatible with POTS appeared, were selected for analysis. Results: We identified 15 patients (3.1% of all positive Tilt test reports) with compatible signs and symptoms. There was a lag of 8 -10 years between the onset of symptoms and the time of diagnosis. Most patients complained of orthostatic intolerance, dizziness and frequent fainting. Orthostatic tachycardia and symptoms occurred on average after 2.9 and 6.1 minutes, respectively,of staying in the standing position. These patients had a high frequency of family history of syncope orpresyncope (66% frequency) and hyper mobility syndrome (53% prevalence). Only 33% of the patients reported relief of their symptoms after being treated (most of them with fludrocortisone). Most patients that reported little or no relief, did not use medications or were treated for a short period. Conclusions: POTS syndrome is uncommon but disturbs quality of life of those who suffer it. Its association with hyper mobility syndromes must be investigated.
Subject(s)
Adolescent , Adult , Child , Female , Humans , Male , Middle Aged , Young Adult , Postural Orthostatic Tachycardia Syndrome/diagnosis , Tilt-Table Test , Cardiovascular Agents/therapeutic use , Case-Control Studies , Fludrocortisone/therapeutic use , Genetic Predisposition to Disease , Postural Orthostatic Tachycardia Syndrome/drug therapy , Postural Orthostatic Tachycardia Syndrome/genetics , Retrospective Studies , Syncope, Vasovagal/genetics , Treatment OutcomeSubject(s)
Humans , Male , Female , Adult , Middle Aged , Evoked Potentials/physiology , Multiple Sclerosis/diagnosis , Follow-Up Studies , Clinical Laboratory Techniques , PrognosisABSTRACT
Se presenta una serie de 24 pacientes sometidos a cirugía carotídea. Entre los métodos de monitoreo cerebral los más difundidos son el EEG y la presión carotídea retrógrada. Una nueva alternativa no conocida entre nosotros es la medición continua de los potenciales evocados somato-sensitivos. En 8 se midió simultáneamente la presión carotídea retrógrada. Fueron operados con o sin shunt transitorio con tiempo medio de oclusión de 23 y 21 minutos respectivamente. El registro se realizó estimulando a través del nervio mediano contralateral. En 23 pacientes no hubo evidencias de isquemia cerebral durante el procedimiento manteniéndose invariable la morfología y latencia de la onda precoz. En el restante sí la hubo, desapareciendo prácticamente la onda evocada precoz, alteración que se revierte al instalar el shunt transitorio. Todos los pacientes despiertan sin daño neurológico. Se concluye que este método de monitoreo de la función cerebral global, no invasivo y de fácil interpretación ha resultado ser un excelente sensor de isquemia cerebral durante la cirugía carotídea, ayudando además a decidir la instalación de un shunt transitorio cuando este se emplea en forma selectiva.