student research day - Case Western Reserve University School of ...
student research day - Case Western Reserve University School of ...
student research day - Case Western Reserve University School of ...
Create successful ePaper yourself
Turn your PDF publications into a flip-book with our unique Google optimized e-Paper software.
Ajitesh Ojha<br />
A Comparison <strong>of</strong> the Incidence <strong>of</strong> Syncope in different orthostatic syndromes<br />
Ajitesh Ojha, K.McNeeley, Dr G. Chelimsky, Dr A Alshekhlee, E. Heller, Dr T Chelimsky<br />
Department <strong>of</strong> Neurology, Department <strong>of</strong> Pediatric Gastroenterology<br />
<strong>Case</strong> Medical Center<br />
Background: There are conflicting opinions on whether POTS predisposes to syncope. We investigated this<br />
relationship.<br />
Materials and Methods:: We queried our autonomic laboratory database <strong>of</strong> over 3500 patients. POTS was<br />
defined as > 30 bpm rise in heart rate within ten minutes <strong>of</strong> upright tilt accompanied by orthostatic symptoms<br />
and further rise in heart rate during the remainder <strong>of</strong> the tilt study. Syncope was defined as an abrupt decrease<br />
in heart rate and blood pressure (less than 3 minutes in duration) requiring termination <strong>of</strong> the tilt table study.<br />
Statistical analysis utilized Fisher’s exact test and <strong>student</strong>’ s t test.<br />
Results: Of 810 patients referred for POTS, 185 met criteria, 329 patients met the criteria for orthostatic<br />
hypotension . 35% <strong>of</strong> POTS patients had tilt syncope while 22 % <strong>of</strong> OH patients had tilt syncope . Analysis <strong>of</strong><br />
clinical syncope in the two groups showed 63 patients(90%) had a history <strong>of</strong> syncope in the POTS group with<br />
tilt syncope while clinical syncope in the orthostatic hypotension group with tilt syncope was observed in 29<br />
patients(40.8%) .<br />
Discussion: Our results demonstrate that even in a large population referred for autonomic dysfunction,<br />
syncope occurs far more commonly in patients who have POTS than in patients with orthostatic hypotension.<br />
Furthermore, there was concordance between tilt syncope and clinical syncope in the POTS group but not in the<br />
orthostatic hypotension group. The high rate <strong>of</strong> correlation between POTS and syncope is striking, and suggests<br />
that these two disorders may actually share a common etiology, or may each constitute a strong predisposing<br />
factor for the occurrence <strong>of</strong> the other.<br />
Key Words: Postural Orthostatic Tachycardia syndrome, syncope, orthostatic hypotension, tilt table test,<br />
dysautonomias<br />
Supported by NIH T35 Training Grant HL082544<br />
67
Change language