Using the Head Up Tilt Test to Diagnose Orthostatic Intolerance

Approximately 500,000 individuals have orthostatic intolerance (OI). OI is defined as a reduction in systolic blood pressure (SBP), or diastolic blood pressure (DBP) by at least 20 and 10 mmHg, respectively within three minutes of standing. During standing, reductions in vasoconstriction contribute to venous pooling and then fainting. OI is a primary symptom in postural orthostatic tachycardia syndrome (POTS). In addition to OI, persons with POTS have reduced exercise capacity. POTS can be diagnosed using various autonomic tests, such as the head up tilt (HUT). The HUT is comprised of a 15-30 min rest in the supine position on a tilt table, followed by tilt to 60 degrees for 30-45 min. During this time, HR, SBP, DBP, and electrocardiogram measures are assessed. Collectively, diagnosis is crucial in order to improve symptoms, exercise tolerance and quality of life. Following diagnosis, appropriate interventions can be made. According to the literature, one of the most effective interventions for improving POTS is a progressive exercise program, which has been reported to be superior to use of pharmacologic agents. In summary, this presentation seeks to address OI in POTS patients, explore a modality for its’ diagnoses, and report exercise interventions to improve POTS.
Presented at Fiat Lux Spring 2021.
Tachycardia, Systolic blood pressure, Cardiovascular system -- Diseases, Cardiovascular system -- Diseases -- Prevention