Paroxysmal orthostatic tachycardia syndrome [POTS] with co-existing chronic fatigue syndrome: a review of three cases and discussion

Orthostatic intolerance appears in many guises including overt dysautonomia, vasovagal syncope and orthostatic tachycardia. We present details of three patients referred to our syncope clinic, who satisfied the chronic fatigue criteria of the centre for disease control and prevention. Head-up tilt testing induced significant hypotension and increased heart rate in all three patients, consistent with the clinical and autonomic manifestations of postural orthostatic tachycardia syndrome. We report on the emerging evidence available which does suggest a direct relationship between these two syndromes