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Posturales Tachykardie-Syndrom (POTS)

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Definition:
Symptomatischer Anstieg der Herzfrequenz (≥ 30 Schläge/Minute) nach dem Aufstehen bei Fehlen einer orthostatischen Hypotonie.
Häufigkeit:
Prävalenz ca. 0,2 %. Beginn am häufigsten bei Jugendlichen und Erwachsenen zwischen 15. und 50. Lebensjahr, das Verhältnis w:m beträgt ca. 5:1.
Symptome:
Benommenheit, Schwindel, Palpitationen, Schwitzen, Zittern, Verschwommensehen, Schwächegefühl. Nur sehr selten Synkope.
Befunde:
Nach dem Aufstehen aus Rückenlage Anstieg der Herzfrequenz ≥ 30 Schläge/Minute. Kein signifikanter Blutdruckabfall.
Diagnostik:
Im Allgemeinen durch Schellong-Test. Im Einzelfall Kipptisch-Untersuchung.
Therapie:
Primär Allgemeinmaßnahmen (körperliches Training, Flüssigkeits- und Salzzufuhr, Kompressionsstrümpfe u. a.). Bei unzureichendem Erfolg ergänzend Medikation (z. B. Propanolol, Fludrocortison u. a.). Die Prognose ist in der Regel gut.
  • Deutsche Gesellschaft für Neurologie. Synkopen. AWMF-Nr. 030-072. S1, Stand 2020. www.awmf.org 
  • Heart Rhythm Society in collaboration with the European Heart Rhythm Association. Expert consensus statement on the diagnosis and treatment of postural tachycardia syndrome, inappropriate sinus tachycardia, and vasovagal syncope. Stand 2015. www.ncbi.nlm.nih.gov 
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  • Michael Handke, Prof. Dr. med., Facharzt für Innere Medizin, Kardiologie und Intensivmedizin, Freiburg i. Br.