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Abstract：
Postural orthostatic tachycardia syndrome (POTS) is a chronic and often disabling disorder characterized by orthostatic intolerance with excessive heart rate increase without hypotension during upright posture. Patients often experience a constellation of other typical symptoms including fatigue, exercise intolerance and gastrointestinal distress. A typical patient with POTS is a female of child-bearing age, who often first displays symptoms in adolescence. The onset of POTS may be precipitated by immunological stressors such as a viral infection. A variety of pathophysiologies are involved in the abnormal postural tachycardia response; however, the pathophysiology of the syndrome is incompletely understood and undoubtedly multifaceted. Clinicians and researchers focused on POTS convened at the National Institutes of Health in July 2019 to discuss the current state of understanding of the pathophysiology of POTS and to identify priorities for POTS research. This article, the first of two articles summarizing the information discussed at this meeting, summarizes the current understanding of this disorder and best practices for clinical care. The evaluation of a patient with suspected POTS should seek to establish the diagnosis, identify co-morbid conditions, and exclude conditions that could cause or mimic the syndrome. Once diagnosed, management typically begins with patient education and non-pharmacologic treatment options. Various medications are often used to address specific symptoms, but there are currently no FDA-approved medications for the treatment of POTS, and evidence for many of the medications used to treat POTS is not robust.
摘要：
体位性心动过速综合征（POTS）是一种慢性且经常致残的疾病，其特征是体位不耐受，在直立姿势期间心率过度增加而没有低血压。患者通常会出现一系列其他典型症状，包括疲劳，运动不耐受和胃肠不适。典型的POTS患者是育龄女性，通常在青春期首先表现出症状。POTS的发作可以通过免疫应激源例如病毒感染来沉淀。异常的姿势性心动过速反应涉及多种病理生理；然而，该综合征的病理生理学尚未完全理解，无疑是多方面的。临床医生和研究人员专注于2019年7月在美国国立卫生研究院召开的POTS会议，讨论对POTS病理生理学的理解现状，并确定POTS研究的优先事项。这篇文章,总结本次会议讨论的信息的两篇文章中的第一篇，总结了目前对这种疾病的理解和临床护理的最佳实践。对疑似POTS患者的评估应寻求确定诊断，确定共病条件，并排除可能导致或模仿该综合征的条件。一旦确诊,管理通常从患者教育和非药物治疗方案开始.各种药物通常用于解决特定症状，但是目前没有FDA批准的用于治疗POTS的药物，许多用于治疗POTS的药物的证据并不可靠。
