Postural orthostatic tachycardia syndrome (POTS) is a clinically heterogeneous disorder with multiple contributing pathophysiologic mechanisms manifesting as symptoms of orthostatic intolerance in the setting of orthostatic tachycardia (increase in heart rate by at least 30 beats per minute upon assuming an upright position) without orthostatic hypotension. The three major pathophysiologic mechanisms include partial autonomic neuropathy, hypovolemia, and hyperadrenergic state. Patients often will exhibit overlapping characteristics from more than one of these mechanisms. The approach to the treatment of POTS centers on treating the underlying pathophysiologic mechanism. Stockings, abdominal binders, and vasoconstrictors are used to enhance venous return in partial neuropathic POTS. Exercise and volume expansion are the main treatment strategies for hypo-volemic POTS. For hyperadrenergic POTS, beta-blockers and avoidance of norepinephrine reuptake inhibitors is important. Attempts should be made to discern which pathophysiologic mechanism(s) may be afflicting patients so that treatment regimens can be individualized.

中文翻译：

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体位性体位性心动过速综合征：机制和新疗法。

体位性体位性心动过速综合征（POTS）是一种临床异质性疾病，具有多种促成的病理生理机制，表现为体位性心动过速的情况下体位性不耐受的症状（假设直立姿势时心率每分钟至少增加30次搏动）而无体位性低血压。三种主要的病理生理机制包括部分自主神经病变，血容量不足和高肾上腺素能状态。患者往往会因多种以上机制而表现出重叠特征。POTS的治疗方法以治疗潜在的病理生理机制为中心。丝袜，腹部粘合剂和血管收缩剂用于增强部分神经性POTS的静脉回流。运动和增加容量是低血容量POTS的主要治疗策略。对于高肾上腺素POTS，β受体阻滞剂和避免去甲肾上腺素再摄取抑制剂很重要。应该尝试辨别可能困扰患者的病理生理机制，以便可以个性化治疗方案。