Outcomes of Adolescent-Onset Postural Orthostatic Tachycardia Syndrome

• Published in: The Journal of pediatrics Vol. 173; pp. 149 - 153
• Main Authors: Bhatia, Roma, Kizilbash, Sarah J., Ahrens, Shelley P., Killian, Jill M., Kimmes, Stephanie A., Knoebel, Erin E., Muppa, Prasuna, Weaver, Amy L., Fischer, Philip R.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.06.2016
• Subjects: Adolescent; autonomic dysfunction; chronic fatigue; dizziness; dysautonomia; Female; Follow-Up Studies; Health Status; Humans; Male; Mental Health; Pediatrics; Postural Orthostatic Tachycardia Syndrome - physiopathology; Postural Orthostatic Tachycardia Syndrome - therapy; Quality of Life; Recurrence; Remission, Spontaneous; Severity of Illness Index; Surveys and Questionnaires; Young Adult; PCS; dizziness; chronic fatigue; autonomic dysfunction; dysautonomia; POTS; MCS; SF-36; Physical component scale; Postural orthostatic tachycardia syndrome; 36-Item Short Form Health Survey; Mental component scale
• ISSN: 0022-3476; 1097-6833
• DOI: 10.1016/j.jpeds.2016.02.035

To determine the clinical course of adolescent-onset postural orthostatic tachycardia syndrome (POTS) and to assess health-related quality of life, 2-10 years after diagnosis. Pediatric patients, 13-18 years of age, diagnosed with POTS at Mayo Clinic, Rochester, from 2003 to 2010 were mailed a questionnaire if they were at least 18 years of age at the time of the mailing. The primary outcome measures were norm-based, age- and sex-adjusted, 36-Item Short Form Health Survey physical composite score and mental composite score. The survey was mailed to 502 patients with a response rate of 34% (n = 172). The mean duration from diagnosis to survey completion was 5.4 (SD, 1.9) years; the mean age of the respondents at the time of the survey was 21.8 (2.2) years. The responders were predominantly females (84% vs 68% of nonresponders; P < .001). Only 33 (19%) respondents reported complete resolution of symptoms, and an additional 51% reported persistent but improved symptoms, and 28 (16%) had only intermittent symptoms. The majority (71%) consider their health at least “good.” The mean physical composite score was significantly lower than the population norm (mean [SD], 36.6 [15.8] vs 50; P < .001), however, the corresponding mean mental composite score was normal (50.1 [11.2]). Overall, 86% of adolescents with POTS report resolved, improved, or just intermittent symptoms, when assessed via questionnaire at an average of 5 years after initial treatment. Patients with persistent symptoms have more physical than mental health concerns.