Excessive Postural Tachycardia and Postural Orthostatic Tachycardia Syndrome in Youth: Associations With Distress, Impairment, Health Behaviors, and Medication Recommendations

Kelsey M. Klaas; Philip R. Fischer; Sara Segner; Michele Tsai Owens; Amy Fahrenkamp; Jennifer Geske; Deanna Hofschulte; Michael Farrell; Cynthia Harbeck-Weber; Bridget K. Biggs

doi:10.1177/08830738221078410

Excessive Postural Tachycardia and Postural Orthostatic Tachycardia Syndrome in Youth: Associations With Distress, Impairment, Health Behaviors, and Medication Recommendations

Kelsey M. Klaas, Philip R. Fischer, Sara Segner, Michele Tsai Owens, Amy Fahrenkamp, Jennifer Geske, Deanna Hofschulte, Michael Farrell, Cynthia Harbeck-Weber, Bridget K. Biggs

Research output: Contribution to journal › Article › peer-review

1 Scopus citations

Abstract

Among adolescents with fatigue and postural dizziness, it is unclear how health behaviors and emotional distress relate to the presence of excessive postural tachycardia. We prospectively evaluated adolescents aged 13-22 years presenting with symptoms suggestive of autonomic dysfunction between September 2017 and December 2018. Patients underwent standard 10-minute, 70-degree head-up tilt testing. Clinician diagnoses and recommendations were recorded from the medical record. Patients completed validated self-report measures of lifestyle factors, autonomic symptoms, depression, anxiety, and functional disability. Of 179 patients, 58 were diagnosed with postural orthostatic tachycardia syndrome and 59 had excessive postural tachycardia, with 90.5% concordance between the 2 groups. Presence of excessive postural tachycardia was associated with greater baseline fluid intake and likelihood of medication prescription in their treatment plan. Medication findings were replicated for postural orthostatic tachycardia syndrome diagnosis. Presence of excessive postural tachycardia or postural orthostatic tachycardia syndrome did not differentiate patients on perceived symptom severity, emotional distress, disability, or health behaviors but did appear to determine treatment recommendations.

Original language	English (US)
Pages (from-to)	599-608
Number of pages	10
Journal	Journal of Child Neurology
Volume	37
Issue number	7
DOIs	https://doi.org/10.1177/08830738221078410
State	Published - Jun 2022

Bibliographical note

Funding Information:
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by the Small Grants Program of the Mayo Clinic Department of Psychiatry & Psychology, which is funded by the National Center for Advancing Translational Sciences at the National Institutes of Health (grant number UL1TR000135). The authors are additionally grateful for the support of the Wahl Research Fund. This study was approved by the Institutional Review Board (Mayo Clinic IRB# 17-003287).

Funding Information:
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by the Small Grants Program of the Mayo Clinic Department of Psychiatry & Psychology, which is funded by the National Center for Advancing Translational Sciences at the National Institutes of Health (grant number UL1TR000135). The authors are additionally grateful for the support of the Wahl Research Fund.

Publisher Copyright:
© The Author(s) 2022.

Keywords

POTS
adolescent
autonomic dysfunction
functional impairment

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10.1177/08830738221078410

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Klaas, K. M., Fischer, P. R., Segner, S., Tsai Owens, M., Fahrenkamp, A., Geske, J., Hofschulte, D., Farrell, M., Harbeck-Weber, C., & Biggs, B. K. (2022). Excessive Postural Tachycardia and Postural Orthostatic Tachycardia Syndrome in Youth: Associations With Distress, Impairment, Health Behaviors, and Medication Recommendations. Journal of Child Neurology, 37(7), 599-608. https://doi.org/10.1177/08830738221078410

Excessive Postural Tachycardia and Postural Orthostatic Tachycardia Syndrome in Youth: Associations With Distress, Impairment, Health Behaviors, and Medication Recommendations. / Klaas, Kelsey M.; Fischer, Philip R.; Segner, Sara et al.
In: Journal of Child Neurology, Vol. 37, No. 7, 06.2022, p. 599-608.

Research output: Contribution to journal › Article › peer-review

Klaas, KM, Fischer, PR, Segner, S, Tsai Owens, M, Fahrenkamp, A, Geske, J, Hofschulte, D, Farrell, M, Harbeck-Weber, C & Biggs, BK 2022, 'Excessive Postural Tachycardia and Postural Orthostatic Tachycardia Syndrome in Youth: Associations With Distress, Impairment, Health Behaviors, and Medication Recommendations', Journal of Child Neurology, vol. 37, no. 7, pp. 599-608. https://doi.org/10.1177/08830738221078410

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abstract = "Among adolescents with fatigue and postural dizziness, it is unclear how health behaviors and emotional distress relate to the presence of excessive postural tachycardia. We prospectively evaluated adolescents aged 13-22 years presenting with symptoms suggestive of autonomic dysfunction between September 2017 and December 2018. Patients underwent standard 10-minute, 70-degree head-up tilt testing. Clinician diagnoses and recommendations were recorded from the medical record. Patients completed validated self-report measures of lifestyle factors, autonomic symptoms, depression, anxiety, and functional disability. Of 179 patients, 58 were diagnosed with postural orthostatic tachycardia syndrome and 59 had excessive postural tachycardia, with 90.5% concordance between the 2 groups. Presence of excessive postural tachycardia was associated with greater baseline fluid intake and likelihood of medication prescription in their treatment plan. Medication findings were replicated for postural orthostatic tachycardia syndrome diagnosis. Presence of excessive postural tachycardia or postural orthostatic tachycardia syndrome did not differentiate patients on perceived symptom severity, emotional distress, disability, or health behaviors but did appear to determine treatment recommendations.",

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note = "Funding Information: The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by the Small Grants Program of the Mayo Clinic Department of Psychiatry & Psychology, which is funded by the National Center for Advancing Translational Sciences at the National Institutes of Health (grant number UL1TR000135). The authors are additionally grateful for the support of the Wahl Research Fund. This study was approved by the Institutional Review Board (Mayo Clinic IRB# 17-003287). Funding Information: The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by the Small Grants Program of the Mayo Clinic Department of Psychiatry & Psychology, which is funded by the National Center for Advancing Translational Sciences at the National Institutes of Health (grant number UL1TR000135). The authors are additionally grateful for the support of the Wahl Research Fund. Publisher Copyright: {\textcopyright} The Author(s) 2022.",

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Excessive Postural Tachycardia and Postural Orthostatic Tachycardia Syndrome in Youth: Associations With Distress, Impairment, Health Behaviors, and Medication Recommendations

Abstract

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