NYMC Faculty Publications
Postural Orthostatic Tachycardia Syndrome: Pathophysiology, Management, and Experimental Therapies
Author Type(s)
Faculty
DOI
10.1080/13543784.2022.2121697
Journal Title
Expert Opinion on Investigational Drugs
First Page
1017
Last Page
1025
Document Type
Article
Publication Date
10-1-2022
Department
Medicine
Abstract
INTRODUCTION: Postural orthostatic tachycardia syndrome (POTS) is an increasingly well-recognized condition encountered in clinical practice. Diagnosis and treatment remain extremely challenging. The limited success of currently available therapies has laid the foundation for a number of experimental therapies. AREAS COVERED: In this review, we will briefly outline the pathophysiology and clinical features of this syndrome, before moving on to its management, with a specific focus on experimental pharmacological therapies. Finally, we briefly discuss POTS related to the SARS CoV-2 (COVID-19) pandemic. EXPERT OPINION: Despite tremendous advances, the diagnosis and management of POTS remains extremely challenging. The multitude of contributory mechanisms, which predominate to varying degrees in different patients further complicates management. Improved characterization of pathophysiological phenotypes is essential to individualize management. Lifestyle measures form the first line of therapy, followed by beta-blockers, ivabradine, fludrocortisone, and midodrine. Supplemental therapies such as iron, vitamin D and α lipoic acid are quite safe and a trial of their use is reasonable. The use of erythropoietin, IVIG, desmopressin, etc., are more specialized and nuanced alternatives. In recent years, interest has grown in the use of cardiac neuromodulation. Though preliminary, some of these therapies are quite promising.
Recommended Citation
Narasimhan, B., Aggarwal, D., Satish, P., Kantharia, B., & Aronow, W. S. (2022). Postural Orthostatic Tachycardia Syndrome: Pathophysiology, Management, and Experimental Therapies. Expert Opinion on Investigational Drugs, 31 (10), 1017-1025. https://doi.org/10.1080/13543784.2022.2121697