Journal of Clinical Pediatrics ›› 2022, Vol. 40 ›› Issue (7): 488-493.doi: 10.12372/jcp.2022.22e0412

• Expert Review • Previous Articles     Next Articles

Diagnosis and treatment of postural tachycardia syndrome in children

LIAO Ying   

  1. Department of Pediatrics, Peking University First Hospital, Beijing 100034, China
  • Received:2022-04-02 Online:2022-07-15 Published:2022-07-08

Abstract:

Postural orthostatic tachycardia syndrome (POTS) is a group of clinical syndromes characterized by chronic orthostatic intolerance and an excessive orthostatic heart rate increment. It is common both in children and adolescents and it can significantly affect children's learning and quality of life. POTS symptoms involve multiple systems and can be associated with multiple comorbidities. Since the clinical manifestations are complex, detailed history taking, correct interpretation of the results of standing test, careful differential diagnosis as well as comprehensive assessment of comorbidities are required when make a diagnosis of POTS for children. The pathogenesis of POTS mainly includes three core mechanisms: central hypovolemia, hyperadrenergic state and vascular dysfunction (partial autonomic neuropathy). In the treatment of POTS children, non-pharmacological therapy should be used as the basis. The main pathogenesis should be evaluated according to the clinical characteristics and certain biomarkers of the children, and attention should be paid to the management of comorbidities, so as to carry out individualized comprehensive treatment.

Key words: postural orthostatic tachycardia syndrome, orthostatic intolerance, standing test, comorbidities, individualized therapy