Autonomic and hemodynamic improvement wiyh the association of beta-blockers with flurocortisone in postural tachycardia syndrome (pots) patients.

Freitas Joao, Santos Rosa; Azevedo Elsa; Costa Ovidio; Carvalho Mario; Falcão de Freitas Antonio

Centro de Estudos da Função Autonómica – Hospital São João
Porto, Portugal

Abstract
Introduction: Orthostatic intolerance (POTS) is a frequent misdiagnosis disabling condition.
Objective: To evaluate the efficacy of drugs in the treatment of the autonomic/hemodynamic disturbance that characterizes POTS patients.
Material and Methods: 9 women, with a mean age 31 years (21 to 57 years), with POTS were evaluated: four pts received oral betablocker (B) therapy, 2 pts flurocortisone (F) and 3 pts association of B and F. The patients were study in basal and tilt position, before (b) and after (a) treatment. HRV, SBPV and spontaneous baroreceptor gain were calculated by FFT and a index. The hemodynamic data was assessed by modelflow-TNOÒ analysis.
Results:

*p<0.05 and **p<0.01 after treatment;f p<0.05 and f f p<0.01after tilt before tretment; Units: HR in bpm; SV in ml; HRV in nu; SBPV in mmHg2; BR in ms/mmHg; TPR in dyn.s.cm-5; SBP in mmHg.
Conclusion: 1- Betablockers and/or flurocortisone improve the clinical and autonomic/hemodynamic disturbance observed in POTS. 2- All medical personnel must be alert to the diagnosis of this disabling misdiagnosis syndrome with such an easy treatment and marked clinical improvement.

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