Oficiálny časopis Slovenskej kardiologickej spoločnosti,
Slovenskej hypertenziologickej spoločnosti a Slovenskej asociácie srdcových arytmií

Cardiology Letters 2026, 35(3):155-163

Prevalencia a prejavy syndrómu ortostatickej tachykardie (POTS) u pacientov s ortostatickou intoleranciou

Monika Lukáčová, Peter Mitro, Kristína Valová
I. kardiologická klinika LF UPJŠ a VÚSCH, a. s., Košice, Slovenská republika

Introduction: Postural orthostatic tachycardia syndrome (POTS) is a form of orthostatic intolerance characterized by an excessive increase in heart rate upon standing in the absence of orthostatic hypotension.

Aim: To assess the prevalence of POTS among patients evaluated for orthostatic intolerance and to analyze symptom characteristics across different POTS phenotypes.

Methods: Between 2021 and 2024, a total of 816 head-up tilt (HUT) tests were performed at our institution for the evaluation of orthostatic intolerance. POTS was diagnosed in 27 patients (3.5%), of whom 17 underwent comprehensive autonomic testing, including the active standing test and the Valsalva maneuver. Symptom burden was assessed using the Malmö POTS Symptom Score.

Results: The mean age of patients was 30.4 ± 7.7 years, and women accounted for 70.6% of the cohort. The most common symptoms were palpitations, presyncope, dyspnea, chest pain, and gastrointestinal complaints. A concomitant vasovagal response during HUT testing was documented in 47% of patients, supporting the existence of an overlap syndrome between POTS and vasovagal syncope. Based on autonomic testing, 57% of patients were classified as having the non-neuropathic POTS phenotype, 36% the neuropathic phenotype and 7.1% the undefined POTS phenotype. No statistically significant differences in symptom profiles were observed among the individual phenotypes.

Conclusion: POTS is a markedly less common form of orthostatic intolerance than reflex or orthostatic syncope. Its clinical presentation is highly heterogeneous and encompasses a broad spectrum of cardiovascular symptoms. Therefore, POTS should be considered in the cardiovascular differential diagnosis of patients without evident structural heart disease. Autonomic cardiovascular function testing enabled the classification of most patients into distinct POTS phenotypes, whereas symptomatology alone did not allow reliable differentiation between them.

Kľúčové slová: postural orthostatic tachycardia syndrome; POTS; orthostatic intolerance; autonomic dysfunction; Malmö POTS Symptom Score

Uverejnené: August 1, 2026  Zobraziť citáciu

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Lukáčová M, Mitro P, Valová K. Prevalencia a prejavy syndrómu ortostatickej tachykardie (POTS) u pacientov s ortostatickou intoleranciou. Cardiology Letters. 2026;35(3):155-163.
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    Referencie

    1. Okamoto LE, Raj SR, Biaggioni I (2012). Chronic fatigue syndrome and the autonomic nervous system. In: Robertson D (ed) Primer on the Autonomic Nervous System. 3rd ed. Academic Press 2012;531-534.
    2. Aboseif A, Bireley JD, Li Y, Li Y, Polston D, and Abbatemarco JR. Autoimmunity and postural orthostatic tachycardia syndrome: implications in diagnosis and management. Cleve Clin J Med 2023;90:439-447.
    3. Raj SR, Fedorowski A, Sheldon RS. Diagnosis and management of postural orthostatic tachycardia syndrome. CMAJ 2022;194:E378-E385.
    4. Feigofsky S, Fedorowski A. Defining cardiac dysautonomia. J Atr Fibrillation 2020;13:2403.
    5. Hamrefors V, Spahic JM, Nilsson D, Senneby M, Sutton R, Melander O, et al. Syndromes of orthostatic intolerance and syncope in young adults. Open Heart 2017;4:e000585.
    6. Schondorf R, Low PA. Idiopathic postural orthostatic tachycardia syndrome. Neurology 1993;43:132-137.
    7. Lloyd MG, Raj SR. Pathophysiology and Classification of PoTS. In: Gall N, Kavi L, Lobo MD (eds). Postural Tachycardia syndrome. Springer 2021:29-34. ISBN 978-3-030-54164-4.
    8. Mar PL, Raj SR. Postural orthostatic tachycardia syndrome: mechanisms and new therapies. Annu Rev Med 2020;71:235-248.
    9. Sebastian SA, Co EL, Panthangi V, Jain E, Ishak A, Sha Y, et al. Postural orthostatic tachycardia syndrome: update for clinical practice. Curr Probl Cardiol 2022;47:101384.
    10. Goodman BP. Evaluation of postural tachycardia syndrome. Auton Neurosci 2018;215:12-19.
    11. Angeli AM, Salonen BR, Ganesh R, Hurt RT, Abdalrhim A, Mueller M, et al. Symptom presentation by phenotype of postural orthostatic tachycardia syndrome. Scientific Reports 2024;14:205.
    12. Spahic J, Fedorowski A, Sutton R, et al. Malmö POTS symptom score: assessing symptom burden in postural orthostatic tachy­ cardia syndrome. Front Cardiovasc Med 2022;10:1113052.
    13. Fedorowski A, Li H, Yu X, Koelsch KA, Harris VM, Liles C, et al. Antiadrenergic autoimmunity in POTS. Europace 2017;19:2111219.
    14. Low PA, Tomalia VA, Park K. Autonomic function tests. J Clin Neurol 2013;9:1-8.
    15. Kim HA, Lee H, Park KJ, Lim JG. Autonomic dysfunction in patients with orthostatic dizziness: validation of orthostatic grading scale and comparison of Valsalva maneuver and head-up tilt testing results. J Neurol Sci 2013;323:61-66.
    16. Jacob LDG, Diedrich L, Sato K, Brychta RJ, Raj SR, Robertson D, et al. Vagal and sympathetic function in neuropathic POTS. Hypertension 2019;73:1087-1096.
    17. Hyung Lee, Kim HA. Diagnostic approach of orthostatic dizziness/ vertigo. Ann Clin Neurophysiol 2023;25:27-31.
    18. Jordan FRJ, Ricci F, Hoffmann F, Hamrefors V, and Fedorowski A, et al. Orthostatic hypertension. Hypertension 2020;75:11511158.
    19. Blitshteyn S, Fedorowski A. The Risks of POTS after COVID-19 vaccination and SARS-CoV-2 infection: more studies are needed. Nat Cardiovasc Res 2020;1:11191120.
    20. Chouksey D, Rathi P, Sodani A, Jain R, Ishar HS. Postural orthostatic tachycardia syndrome in patients with orthostatic intolerance: an ambispective study. AIMS Neurosci 2020;8:74-85.
    21. Raj SR (2006). The Postural Tachycardia Syndrome (POTS): pathophysiology, diagnosis & management. Indian Pacing Electrophysiol J 2006;6:84-99.
    22. Okamoto LE, Urachie V, Rigo S, Abner, JJ, Giesecke M, Muldowney JAS, et al. Hyperadrenergic postural tachycardia syndrome: clinical biomarkers and response to guanfacine. Hypertension 2024; 81:2237-2247.
    23. Vernino S, Bourne KM, Stiles LE, Grubb BP, Fedorowski A, Stewart JM, et al. POTS: state of the science. Auton Neurosci 2021;235:102828. doi: 10.1016/j.autneu.2021.102828.
    24. Raj SR, Guzman JC, Harvey P, Seifer C, Thibodeau-Jarry N, Sheldon RS, et al. Canadian Cardiovascular Society position statement on POTS. Can J Cardiol 2020;36:357-372.

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