Dysautonomias: Approach and Management

Dr. Satish Raj discusses the approach and management of Postural Orthostatic Tachycardia Syndrome (POTS) in a recent Grand Rounds session, highlighting its definition, symptoms, diagnostic criteria, and treatment strategies. POTS is characterized by a significant increase in heart rate upon standing without hypotension and is more prevalent in young females. It is often associated with conditions like Ehlers-Danlos Syndrome (EDS) and potentially Mast Cell Activation Syndrome (MCAS). Non-pharmacological treatment includes increased salt and fluid intake, compression garments, and graded exercise programs. Pharmacological options like low-dose beta blockers, ivabradine, and others are considered based on individual patient needs. Diagnosis can often be made in primary care, with specialist referrals for refractory cases. Dr. Raj emphasizes the importance of coping strategies and a multidisciplinary approach for managing this chronic condition.