Postural orthostatic tachycardia syndrome in a Thai male patient
Issued Date
2024-01-01
Resource Type
ISSN
09599851
eISSN
16191560
Scopus ID
2-s2.0-85197850363
Journal Title
Clinical Autonomic Research
Rights Holder(s)
SCOPUS
Bibliographic Citation
Clinical Autonomic Research (2024)
Suggested Citation
Kulapatana S., Diedrich A., Lersritwimanmaen P., Watanapa W.B. Postural orthostatic tachycardia syndrome in a Thai male patient. Clinical Autonomic Research (2024). doi:10.1007/s10286-024-01044-1 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/99707
Title
Postural orthostatic tachycardia syndrome in a Thai male patient
Corresponding Author(s)
Other Contributor(s)
Abstract
Postural orthostatic tachycardia syndrome (POTS) is a heterogeneous autonomic disorder. All patients have exaggerated tachycardia upon standing, but the pathophysiology may be diverse. We present a young adult Thai male with a chief complaint of palpitations while in an upright posture since childhood. The patient underwent a modified Ewing test battery which included standing test, deep breathing, and Valsalva maneuver. His heart rate increased more than 30 beats per minute (bpm) during repeated active stand tests (65 to 110 bpm and 77 to 108 bpm), while upright diastolic blood pressure increased more than 10 mmHg. Normal Valsalva ratio (2.01 and 1.86) and baseline heart rate variability (HFRRI = 4030.24 ms2 and 643.92 ms2) indicated intact vagal function. High low-frequency systolic blood pressure variability (LFSBP = 20.93 mmHg2), increased systolic blood pressure overshoot in phase IV of Valsalva (42 mmHg), and increased upright diastolic blood pressure indicated a hyperadrenergic state. In conclusion, the overall autonomic profile was compatible with hyperadrenergic POTS. Thus, we confirmed the first male POTS case reported in Thailand. We demonstrated the importance of autonomic function testing with continuous measurements to confirm POTS. There is a need for further research in POTS in Thailand.