Postural Orthostatic Tachycardia Syndrome

Tachycardia: Tachycardia typically refers to a heart rate that exceeds the normal range for a resting heart rate. When the heart beats rapidly, the heart pumps less efficiently and provides less blood flow to the body and the heart. The rapid heartbeat increases the workload and oxygen demand of the heart. Problems will occur with the heart as tachycardia persists over time. The heart is maintaining less oxygen, which will lead to an MI due to death of the myocardial cells. Patient will start to have angina because of this. Tachycardia is noted in many diseases and disorder like: fever endocarditis, anemia, HTN, pericarditis, abnormal heart impulses, anxiety, older age, sleep apnea, COPD, electrolyte imbalances, and many more.

Sinus bradycardia is defined as a heart rate of less than 60bpm in conjunction with normal sinus rhythm. A bradyarrhythmia, on the other hand has a disturbance in cardiac conduction with rate of less then 60bpm (Swift, 2013). Intrinsic and extrinsic etiologies contribute to bradycardia. Intrinsic causes relate to abnormalities in the conduction system, where extrinsic causes include: increase vagal tone, electrolyte imbalance, hypoxia, hypothermia and hypothyroidism (Swift, 2013).

The patient, Meriem Haile has been complaining of chest pains along with many other symptoms. She had cardiac catheterization, coil occlusion of PDA, done at the age of 16, for congenital defect. Now she has been diagnosed with SVT (supraventricular tachycardia), occurring 8% of the time. She complains of headaches that come after any physical activity, such as going up stairs. She used to be able to run cross country, but now stopped doing any exercise due to the recurring headaches. She also complains of experiencing blackout when standing up from a sitting position.

Postural Orthostatic Tachycardia Syndrome (POTS) is a condition in which blood volume decreases when standing up. The flow of blood through the body is affected causing dizziness and fainting. When the patient stands up, blood pressure drops and heart rate rapidly increases. Some patients have minor symptoms and perform everyday activities while others can have severe symptoms that cause even the simplest task to be almost impossible. This condition is very rare and usually affects more women than men. The age range is between twenty to fifty years old. It takes time and effort to properly diagnose POTS. This includes keeping a journal of symptoms and occurrences along with medical evaluation.

cause slower heart rates [95]. We cannot rely solely on reduced heart rates only to diagnose CAN because with advanced nerve dysfunction, heart rates can be normal [95] but it persists in higher rates than patients without any diseases [96]. As a result, heart rate cannot be a reliable factor to determine CAN; however, decreased heart rate is the primary manifestation of CAN [95]. CAN is considered as a common chronic complication of diabetes mellitus that threatens life of patients with diabetes [97]. Its worldwide prevalence varies from 1.6% to 90% [98]. Dysfunction of autonomic nerve fibers that regulate heart rate, cardiac output, myocardial contractility, cardiac electrophysiology, blood vessel constriction and dilatation can be defined as CAN [97, 99]. There are many cardiac disorders that are associated with CAN such as resting tachycardia, intraoperative cardiovascular instability, arrhythmias, asymptomatic myocardial infarction and ischemia and increased rate of mortality after myocardial infarction [97, 99]. CAN is diagnosed by several clinical symptoms, such as postural hypotension, dizziness, light headedness, presyncope, syncope and early fatigue and exhaustion during exercise; all of these are demonstrated in later stages [98]. The first finding of CAN is, decreased heart rate variability (HRV), which is a subclinical finding and can be diagnosed through deep respiration [100]. It can occur even in normal heart rate conditions [100]. Increased resting heart

When something goes wrong with the autonomic nervous system, it can cause serious problems. Postural Orthostatic Tachycardia Syndrome (POTS) is an abnormality of the autonomic nervous system, commonly defined as an inability to regulate the heart rate (Rowe 6). Patients with POTS will experience symptoms that can limit daily activity and function (Agarwal et al. 478). Although treatment can be challenging, patients with POTS that take an active role in the diagnosis and management of their care can improve their quality of life.

Syncope is a common symptom of cerebral ischemia caused by various causes. The prevalence of inherited arrhythmias account for syncope is low. However, the syncope caused by inherited arrhythmias has possibility of indication of cardiac arrest and death and reported to be correlated with increased risk of sudden cardiac arrest. Long QT sy drome is a typical inherited arrhythmiacause syncope in children. Beta-blockers are clinically indicated in LQTS and effective for preventing recurrence of syncope. Brugada syndrome is also typical inherited arrhythmia cause syncope or sudden cardiac arrests in young individuals. The syncope is important for the risk stratification and therapeutic selection. Cathecolaminergic polymorphic ventricular

The people who are at a high risk of suffering from TTS are women especially those who are sixty and above. However, younger men and women can also be affected. Majority of the Clinicians usually suspect that hyper release of catecholamine is the actual reason as to why people suffer from TTS. Furthermore, the pathophysiology that mainly causes cardiomyopathy is not well known; however, under normal physiological environment anything that causes stress stimulates sympathetic nervous system and it responds by triggering the release of noradrenalin and adrenaline (catecholamine). This response result by increasing vasoconstriction and heart rate which makes the blood pressure to rise (Hjemdahl, P., Rosengren, A., & Steptoe, A., 2012).

A recent study shows 1:4 American adults over the age of 40 are at risk of developing an abnormal heart rhythm (www.myvmc.com). Once an arrhythmia has been diagnosed an antiarrhythmic agent can be prescribed. It is important that when taking an antiarrhythmic medication, directions or how it should be taken is followed precisely. As long as the antiarrhythmic agent is taken as prescribed, they will help prevent further complication, such as heart attacks and heart

Vasovagal Syncope, also known as fainting, neurocardiogenic syncope, and neurally mediated syncope, is a very common condition, occurring in roughly half of all people at least once within their life; three percent of the population develops it repeatedly. It is not a serious condition.(2) A vasovagal response involves a decrease in the volume of blood that is returned to the heart, which enervates the baroreceptors(2) in the sympathetic nervous system to increase the force of each contraction of the heart. Consequently, the opposing parasympathetic nervous system is alerted to slow the heart rate and dilate the surrounding veins and arteries. These responses of the nervous system cause the blood pressure to drop very low, causing syncope (loss of consciousness).(1) Most patients are young and healthy, although vasovagal syncope can occur in the elderly population that has preexisting cardiac problems. Extremely hot weather and blood-alcohol levels are typical triggers. Some patients suffer from several, often attacks, while others may only experience them sporadically.(3)

A 65-year-old man with ischemic cardiomyopathy (left ventricular ejection fraction <20%) and ventricular tachycardia was treated with a left ventricular assist device (LVAD) (HeartWare, Framingham, MA) as a bridge to transplant and biventricular implantable cardioverter/defibrillator (ICD; Boston Scientific, Natick, MA). The patient was admitted after he experienced multiple discharges of his ICD. A review of the ICD’s memory showed multiple occurrences of symptomatic non-sustained ventricular tachycardia (NSVT). The patient was started on mexiletene, but continued to have symptomatic episodes of VT. Ultimately, the patient required a continuous infusion of amiodarone to control the arrhythmia. The patient was discharged after being transitioned to an oral regimen of amiodarone and mexiletene. He was readmitted two days later with complaints of burning

I was fortunate to acquire a position under a cardiologist and was amazed to see the time-saving advanced diagnostic technologies, research innovations, and patient-centered care and management. My responsibilities included assisting the staff in the diagnostic procedures, taking patient notes and working with the research team on the recent advancements, clinical trials, case reports, abstracts and manuscripts in cardiology especially focused on Postural Orthostatic Tachycardia Syndrome (POTS). POTS is a form of an autonomic disorder that is very common around the world. It occurs more commonly in young women with no treatment except for symptomatic improvement. This made me interested to know the root cause, treatment options, and significant correlations of POTS and was suggesting new research ideas on the subject. I have published 29 abstracts in various high impact journals as primary author and co-author. Four of my abstracts were accepted as novel therapies for the first time in the treatment of POTS. I was overwhelmed when two of my abstracts were accepted as late breaking abstracts and one was among the top 10% of accepted abstracts, leading to an invitation to present at the American Heart Association 2015 annual scientific meeting. When I presented my abstracts in various annual meetings, I felt honored to share the platform with the

There are many things that can cause or contribute to problems with the heart's electrical system. A number of informed medical professionals believe there are a number of factors and disorders that point to disturbance within the autonomic nervous system. Ideally, your doctor should consider and treat the cause of sinus tachycardia rather than the condition itself. Several other specific and treatable medical disorders can be confused with sinus tachycardia, and in a patient presenting with an abnormal sinus tachycardia, these other causes need to be ruled out. If your rapid heartbeat is a symptom of a more serious or longer term problem, simply slowing the heart rate could cause more harm and leave the underlying condition

If You Are Suffering from Tachycardia or Some Type of Arrhythmia Solve These Problems within a Minute without Any Medications

When a patient has a heart rhythm of ventricular tachycardia, is the “repetitive firing of an irritable ventricular ectopic focus, usually at a rate of 140 to 180 beats/min or more” (Ignatavicius & Workman, 2016, p.670); by having such high heart beats it can damage the heart muscle. Now that the nurse is aware that Mrs. Byong has VT, she would need to continue monitoring the heart rhythm for any further complication that could arise. The nurse would have to administer prescribed