Postural Tachycardia Syndrome: A Concise and Practical Guide to Management and Associated Conditions PDF
Preview Postural Tachycardia Syndrome: A Concise and Practical Guide to Management and Associated Conditions
Postural Tachycardia Syndrome A Concise and Practical Guide to Management and Associated Conditions Nicholas Gall Lesley Kavi Melvin D. Lobo Editors Postural Tachycardia Syndrome Nicholas Gall · Lesley Kavi · Melvin D. Lobo Editors Postural Tachycardia Syndrome A Concise and Practical Guide to Management and Associated Conditions Editors Nicholas Gall Lesley Kavi King’s College Hospital Faculty of Health, Education and Life London, UK Sciences, Birmingham City University Birmingham, UK Melvin D. Lobo Barts NIHR Biomedical Research Centre, William Harvey Research Institute, Queen Mary University of London London, UK ISBN 978-3-030-54164-4 ISBN 978-3-030-54165-1 (eBook) https://doi.org/10.1007/978-3-030-54165-1 © Springer Nature Switzerland AG 2021 This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. The publisher, the authors and the editors are safe to assume that the advice and information in this book are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or the editors give a warranty, expressed or implied, with respect to the material contained herein or for any errors or omissions that may have been made. The publisher remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. This Springer imprint is published by the registered company Springer Nature Switzerland AG The registered company address is: Gewerbestrasse 11, 6330 Cham, Switzerland Foreword Postural Tachycardia Syndrome is common, distressing, and has symptoms reaching far beyond simple postural tachycardia. Fortunately, we have seen recent rapid progress in studies of its origin and pathogenesis. Similarly, progress in clinical management that was slow for many years, has accel- erated considerably. There are even recent consensus statements from the Heart Rhythm Society and the Canadian Cardiovascular Society. However, these statements usually provide only simple and high-level directions on what should, could, and shouldn’t be done, without tools on how to actually do it. This beautiful and comprehensive volume fills the gap, with numerous chapters providing insight, wisdom, and tools to help assessment and care. Sir William Osler once wrote that a good physician treats the disease, but a great physician treats the patient who has the disease. The authors provide an all-round approach, from the initial clinical presentation by Dr. Gall to the crucial issue of psychological support for these all too often highly dis- tressed patients, written by Drs. Opie, Raj, and Arnold. Read it from cover to cover, or pick it up and dip in and out, then take it to help your patient. It will stand both of you in good stead for times to come. Prof. Dr. Robert Sheldon Cardiac Sciences, Libin Cardiovascular Institute Cumming School of Medicine University of Calgary Calgary, AL, Canada e-mail: [email protected] v Contents POTS, An Introduction Introduction .............................................. 3 Nicholas Gall Historical Background ..................................... 7 Kelsey Klaas and Lesley Kavi Clinical Presentation ....................................... 11 Nicholas Gall Specialty Assessment Diagnostic Criteria for Postural Tachycardia Syndrome: Consideration of the Clinical Features Differentiating PoTS from Other Disorders of Orthostatic Intolerance .......... 19 Kate M. Bourne, Matthew G. Lloyd and Satish R. Raj Pathophysiology and Classification of PoTS ................... 29 Matthew G. Lloyd and Satish R. Raj Cardiological Considerations: Tests to Consider, Are They Useful and What Do They Show? .................... 41 Tushar V. Salukhe Neurological Investigations ................................. 43 Robert Shane Delamont The Active Stand and Tilt Tests .............................. 47 Matthew G. Lloyd, Kate Bourne and Satish R. Raj Additional Autonomic Tests ................................. 53 Peter Oketa-Onyut Julu and Melvin D. Lobo Cardiovascular Red Flag Symptoms in PoTS .................. 61 Szablocs Nagy and P.Boon Lim Neurological Red Flags in Common Neurological Conditions Associated with PoTS ...................................... 63 Evangelia Theochari vii viii Contents Associated Conditions Rheumatology and Postural Tachycardia Syndrome ............ 75 Alan J. Hakim, Jane V. Simmonds and Arvind Kaul Headache in Postural Tachycardia Syndrome .................. 93 Linda D’Antona and Manjit Matharu Postural Tachycardia Syndrome and Sleep .................... 103 Guy Leschziner Investigations of Endocrinopathies ........................... 109 Abbi Lulsegged Postural Tachycardia Syndrome and the Gut .................. 115 Alicia Green and Asma Fikree Urological Considerations in PoTS ........................... 125 Visha Tailor and Vik Khullar Gynaecological Considerations in PoTS ....................... 141 Visha Tailor and Vik Khullar Dizziness—The Audiovestibular Perspective ................... 153 Louisa Murdin and Katherine Harrop-Griffiths Other Conditions Linked to PoTS Is PoTS an Autoimmune Condition? .......................... 163 Gurvinder Rull and Melvin D. Lobo Mast Cell Activation Syndrome (MCAS) ...................... 171 Clive E.H. Grattan Inherited Metabolic Diseases ................................ 187 Radha Ramachandran Chronic Fatigue Syndrome ................................. 191 Julia Newton Lyme Disease ............................................. 193 John Lambert and Anne Cruikshank Therapy Non-pharmacological Management (Hydration, Diet and Compression) ......................................... 199 Helen Eftekhari and Diane L. Bruce Exercise Guidelines for Postural Tachycardia Syndrome ......... 207 I. De Wandele, D. Low, P. Rowe and J.V. Simmonds Medication in PoTS: An Overview ........................... 217 Nicholas Gall Contents ix Midodrine ............................................... 221 Nicholas Gall Ivabradine ............................................... 225 Tushar V. Salukhe β-blockers ................................................ 227 P.Boon Lim Fludrocortisone ........................................... 229 Melvin D. Lobo Octreotide ............................................... 231 Melvin D. Lobo Clonidine ................................................ 233 Carmela Maniero and Melvin D. Lobo Other Medications: Desmopressin, Pyridostigmine, Erythropoietin and SSRIs .................................. 237 Mehran Asgari and Melvin D. Lobo Assessing Benefit in PoTS ................................... 241 Nicholas Gall Additional Therapeutic Considerations Clinical Aspects of Paediatric PoTS .......................... 247 Philip R. Fischer, Lesley Kavi and William Whitehouse Pregnancy and Postural Tachycardia Syndrome ................ 253 Daniel Borlase and Cathy Nelson-Piercy Anaesthetic Considerations ................................. 263 Peter William Vaughan Wicks and Roger Cordery Respiratory Specific Diagnostic Tests and Physiotherapy Intervention for Patients with PoTS Presenting with Breathlessness ............................................ 267 Charles C. Reilly, Sarah V. Floyd and Kai K. Lee Psychological and Psychiatric Support; When, Why and What to Do ........................................... 271 Morwenna Opie, Vidya Raj and Amy C. Arnold Service Models PoTS in Primary Care ..................................... 291 Lesley Kavi Nurse-Led PoTS Clinics: A Framework ....................... 295 Melloney Ferrar and Helen Eftekhari x Contents A Tertiary Referral Centre for PoTS: The Autonomic Unit at the National Hospital for Neurology and Neurosurgery Experience ............................................... 303 Valeria Iodice and Christopher J. Mathias The Management of PoTS in a District General Hospital, A Personal View. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 309 Diane Bruce A Tertiary Hospital Cardiology Model of Care ................. 315 Nicholas Gall Patient Considerations PoTS from a Patient’s Perspective ............................ 319 Lesley Kavi and Lorna Nicholson Living with the Ehlers-Danlos Syndromes (EDS)—The Patients’ Perspective ....................................... 323 Kay Julier Index .................................................... 329
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