Le syndrome de tachycardie posturale (PoTS)Â : une maladie pour l'interniste

Postural tachycardia syndrome (PoTS) is a multifactorial syndrome defined by an increase in heart rate ≥ 30 bpm, within 10 minutes of standing (or during a head up tilt test to at least 60°), in absence of orthostatic hypotension. It is associated with symptoms of cerebral hypoperfusion that are worse when upright and improve in supine position. Patients have an intense fatigue with a high incidence on quality of life. This syndrome can be explained by many pathophysiological mechanisms. It can be associated with Ehlers-Danlos disease and some autoimmune disorders. The treatment is based on nonpharmacological measures and treatment with propranolol, fludrocortisone or midodrine.