Abstract Details

Title How Important Is the T in POTS Using Pediatric Versus Adult Diagnostic Criteria for Postural Tachycardia?

Topic Autonomic Disorders

Presentation(s) P03 - (-)

Poster/Presentation
Number 037

Objective

Background BACKGROUND: Published reports of pediatric POTS have used adult values of heart rate increment (HRinc) or absolute HR (HRabs). However, normative pediatric data point to higher HR cut off values than adults.

Design/Methods DESIGN/METHODS: We reviewed the records of 64 patients evaluated between April 2007-March 2011 for probable POTS by standing or head-up tilt test (HUT) or both at a Tertiary Pediatric Neurology Clinic. POTS-pc (pediatric criteria) was defined as frequent, 2 or more symptoms of OI for >3 mo and HRinc of ?40 or HRabs ?120 bpm ages 14-19 and HRabs ?130 ages 8-13 y. Diagnosis of POTS-ac-only (adult criteria) used HRinc of ?30 but <40 bpm or HRabs ?120 but <130 bpm in ages 8-13 y, within 10 min of active standing or HUT, without hypotension. Data are presented as means ±SD.

Results RESULTS: 32 patients had POTS-pc (81% female; age 15±1.8 y); with mean duration of symptoms of 1.8 y. Pre-existing conditions included ADHD (19%), anxiety (22%), and depression (16%). Symptoms included chronic fatigue (81%), sweating disorder (59%), sleep disorder (57%), nausea (58%), abdominal pain (39%), vomiting (26%), weight loss (35%), brain fog (32%), and migraine (31%). Quantitative sudomotor axon testing was abnormal in 14 of 25 patients (56%), abnormal GI motility with gastroparesis in 5/24 (21%), and slow gastric emptying in 7/10 (70%). There were 30 patients with POTS-ac-only who had similar phenotype to the POTS-pc group without significant statistical differences in prevalence of age, sex, duration of symptoms, pre-existing conditions, symptoms, test results, or outcome.

Conclusions CONCLUSIONS: Children and adolescents with POTS diagnosed using a modified pediatric criteria have a similar phenotype to those who only meet adult criteria. We propose a diagnosis of probable POTS for the latter group.

Authors/Disclosures
Imad T. Jarjour, MD, FAAN (Baylor College of Medicine) PRESENTER	No disclosure on file
Adriana Hernandez	No disclosure on file
Laila K. Jarjour, MB ChB MPH (Baylor College of Medicine)	No disclosure on file
Mark Wainwright, MD, PhD, FAAN (Division of Neurology Seattle Childrens Hospital)	Dr. Wainwright has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sage Therapeutics.

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