Postural Orthostatic Tachycardia Syndrome (POTS)

Wobbler syndrome is a disease of dogs that affects their spine in the neck region and is a very important and common cause of neurologic disability in large breed dogs. Wobblers disease is classified under a degenerative or idiopathic disease. Wobbler syndrome or wobblers is the most common name used but Veterinary literature has used multiple different names to describe this condition, this is in part due to the confusion regarding the mechanisms causing it. The name most commonly used in veterinary articles is cervical spondylomyelopathy (which means a disease of the neck vertebrae affecting the spinal cord). Other common names are CVI – cervical vertebral instability, CVM – cervical vertebral malformation, CVMM – cervical vertebral malformation-malarticulation,

Complex regional pain syndrome (CPRS) formerly known as reflex sympathetic dystrophy is an autonomic and central nervous system disease that results in an individual’s experiencing chronic pain (Ferrillo, 2016). Pain usually happens in one or more generalized region of the extremities, such as the arms, hands, legs, or feet, but can also affect other parts of the body. Although the particular origin of the disease is undetermined, the majority of the time CRPS is caused by a significant trauma; such as a fracture, sprain, burn, cut, bruise, limb immobilization, or a surgical procedure (Ferrillo, 2016). CRPS stems from a neurological dysfunction that generates severe pain, mild or dramatic changes in skin color, temperature, and swelling in the affected area (National Institute of Neurological disorders and Stroke, 2015). There are two types of complex regional pain syndrome, type I is no apparent nerve injury and may it develop following a noxious event that may or may not have been traumatic. Types II develop after a nerve injury of the affected area (Carr, Cerda, & Fiala, 2016).

Julie McGovern has struggled with chronic illness for most of her life. After a bout with mononucleosis in childhood, her autonomic nervous system became irreversibly damaged, causing her to develop Postural Orthostatic Tachycardia Syndrome (POTS).

Lots of people have Hypermobility type without even knowing it. One of the symptoms for hypermobility type of EDS is Cronin pain, people with EDS have to struggle with this pain each and every day. Another symptom is dislocations, or when something comes out of its proper place in the body, and the breaking of bones. Along with this form of EDS it is linked with potheraul orthostatic tachycardia syndrome. This causes the blood pressure to plummet and all blood rush to the feet causing someone to loose conciseness. Most people who are diagnosed are women because this disease is harder to find in males.

History of present illness: 34-year-old woman with a history of Wolff Parkinson White Syndrome complains of intermittent palpitations since 2005. She has had a 24-hour Holter, which was unremarkable. She came in for a follow-up visit and had an EKG done that revealed the presence of pre-excitation. The patient reports a daily sensation of palpitations that lasts for several minutes. The patient reports lightheadedness with the palpitations without syncope. The patient underwent an exercise treadmill evaluation, which showed no evidence of ischemia. The echocardiography revealed a structurally normal heart. Delta waves were noted during evaluation but resolved at higher heart rates.

There are many ways to treat Postural Orthostatic Tachycardia Syndrome or POTS for short. Certain medicines, such as midodrine, propranolol, or antidepressants, can help, but another way to treat POTS is to undertake a lifestyle change. Although it is the opposite of what they might want to do, exercise is a key factor in helping a POTS patient. How do we know exercise is important when it comes to POTS? The American Heart Association published an article on June 20th, 2011 about the effects of exercise treatment for POTS patients. This research was done by Qi Fu, Tiffany B. VanGundy, Shigeki Shibata, Richard J. Auchus, Gordon H. Williams, and Benjamin D. Levine at the Institute for Exercise and Environmental Medicine in Texas. These researchers

with two or more circulating waves such as those shown in Figs. 2(a) (multimedia view) and 2(e) (multimedia view)

MSA-C patients may experience a form of tremor known as action tremor, which occurs when they reach for an object. Muscle weakness associated with MSA-C can lead to slurred speech and problems swallowing. This form of MSA can appear as early as the 40’s or not until the 60’s. Dysautonomia in MSA leads to problems regulating heart rate, blood pressure, breathing, digestion and other internal organ functions. Patients may become dizzy or faint when they sit up or stand up; a condition known as neurogenic orthostatic hypotension. Loss of bladder or bowel control, abnormal sweating, sexual impotence in men and sleep disturbances, including sleep apnea, and flailing movements during sleep also

For instance, while the POTS patients did experience symptoms of a panic attack that corresponded during increased orthostatic intolerance during all three stimuli’s, resolution of symptoms occurred directly after testing was completed or they were placed back into supine position (Khurana, 2006). Also, POTS patients had no prior history or family history of PD and some common cognitive symptoms of PD patients (such as fear of dying or feelings of detachment) were not reported by the patients with POTS. As expected, no symptoms were noted in any member of the control group. However, the most interesting and influential finding of this study was that personality patterns were different between the disorders, with POTS patients scoring in a normal

Mr S is tachycardic (Awtry, Jeon, & Ware, 2006), which means that there is disruption of the normal electrical impulse. The presence of atrial fibrillation would suggest that the disruption in electrical activity is occurring in the left atrium rather than the sinus node. If the heart rate has been elevated for a prolonged period it could lead to tachycardia induced cardiomyopathy (TIC) which can lead to HF (Patel & Whittaker, 2007). The increase in resting bpm is a compensatory mechanism used to maintain cardiac output when there is a loss in pumping capacity (Watson, Gibbs, & Lip, 2000). The potential diagnosis of heart disease or failure is further evidenced by no palpable apex beat. This displacement of the apex beat usually indicates cardiomegaly; cardiomegaly is a sign that the heart cannot keep up with its workload and so enlarges to compensate (Madhok et al., 2008). This enlarged heart starts to retain fluid, causing the lungs to become congested and can potentially result in the irregular pulse found on investigation (Kruijt & Turin, 2012). This excessive fluid in the airways can also be the cause of inspiratory crackles. If on examination there appeared to be transudate, this can help to add to the clinical suspicion of chronic heart failure. The character of the crackle can also help in diagnosis; a moist late inspiratory crackle suggests restrictive (alveolar)

I improved application of professional knowledge during my preceptorship. I always remembered that the focus of my professional practice are my clients and their needs. I planned care with the patient and used best practices to recommend plan of care. I discussed the comfort and pain management with the client and recommended to adjust daily routine ,transfer and pain medication to minimize the patients discomfort. I used knowledge base to rule out possible causes of tachycardia such as drug interaction, anemia, unexpected blood flow changes, possible blood loss?. I assessed the patients for signs of weakness, dizziness and peripheral edema .I also measured the patients VS,Resp,LOC,Spo2.. I checked the patient’s history for cardiac issues,

Based on the information in the case study, it is likely that Mrs Tim has suffered a Transient Ischaemic Attack (TIA). A TIA is when there is a temporary restriction to blood flow in the brain, which causes a deficit in neurological function (Koutoukidis, Stainton, & Hughson, 2013). The duration is anywhere between a couple of minutes through to 24 hours. The main causes of TIA’s are: an occlusion caused by a micro-emboli; arteriole spasm (Chang, Daly, & Elliott, 2006); or a small brain haemorrhage. Without the blood flowing, the brain cannot get the oxygen it needs and brain cells begin to die. However, once the blood flow is restored, oxygen is distributed and brain function is once again restored (National Stroke Foundation - Australia,

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

The world of science is bursting with rectifications and when it comes to medicine, it is scientist’s goal to prescribe what is best for the patient. A doctor cannot prescribe what is best for a patient if they do not even fully understand the disease they are facing. Postural Orthostatic Tachycardia Syndrome (POTS) is one of the many diseases we do not know about and it makes sense that many doctors would turn out to be treating its symptoms incorrectly. Our knowledge on medication has grown over the years in the case of POTS and we have come to learn that there are medicines we should not prescribe to the patients. These medicines happen to be any type of norepinephrine reuptake transporters (NRI) that contain atomoxetine. This type of medicine

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