J Korean Child Neurol Soc.  2017 Sep;25(3):156-161. 10.26815/jkcns.2017.25.3.156.

Orthostatic Hypotension and Postural Orthostatic Tachycardia Syndrome in Children: Comparison of Clinical Features and Neurophysiology Test

Affiliations
  • 1Department of Pediatrics, Keimyung University School of Medicine, Daegu, Korea. joung756@dsmc.or.kr

Abstract

PURPOSE
The clinical characteristics and neuropsychological tests of orthostatic hypotension (OH) and postural orthostatic tachycardia syndrome (POTS) in children were compared.
METHODS
From August 2011 to April 2015, we enrolled patients who visited hospital with dizziness or syncope. According to the results of head-up tilt test (HUTT), the patients were classified into 4 groups; OH group, POTS group, normal group I who had no orthostatic symptom during HUTT, and normal group II who had orthostatic symptom during HUTT.
RESULTS
Eighty-eight patients were enrolled with 11(12.5%) in OH group, 13(14.7%) in POTS group, 49(55.7%) in normal group I and 15(17.0%) in the normal group II. During HUTT, the temporal changes of systolic, diastolic, and mean blood pressure of OH group were significantly different from those of POTS group, normal group I, and normal group II. Heart rate changes after tilt showed increase trend in all 4 groups and there was no significant different between OH and POTS group. In normal group II, the temporal changes of diastolic and mean blood pressure were similar to those in POTS group and were significantly different from normal group I. In the autonomic nervous system test, the heart rate response to deep breathing (HRDB) was significantly different between normal group I and II
CONCLUSIONS
In pediatric OH patients, heart rate may be increased with blood pressure fall. And if orthostatic symptoms are associated with HUTT, we should not exclude OI even if the test result do not meet the criteria for diagnosis.

Keyword

Orthostatic hypotension; Postural orthostatic tachycardia syndrome; Children

MeSH Terms

Autonomic Nervous System
Blood Pressure
Child*
Diagnosis
Dizziness
Heart Rate
Humans
Hypotension, Orthostatic*
Neurophysiology*
Neuropsychological Tests
Postural Orthostatic Tachycardia Syndrome*
Respiration
Syncope
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