Comparison Of Health Education, Oral Rehydration Solution, Metoprolol And Midodrine Intervention In Children With POTS

Background:The postural orthostatic tachycardia syndrome (POTS) is heterogeneous group of disorder. The aim of this study is to evaluate the clinical features and the effectiveness of non pharmacological and pharmacological treatment in patients with POTS.Method:A retrospective medical record analysis of the patients referred to Pediatric Cardiology Unit of our Second Xiangya Hospital of Central South University since June 2003 to February 2010. This study included 33 children patients aged 6 to 16 years old (mean 11.24±2.35 years) among 17 male (mean 10.62±2.88 years) and 16 female (mean 11.81±1.64 years) after medication within 14 days to 6 months with follow up record. Total 33 patients are compared after medication and also compared by dividing into 4 treatment method groups, health education group (n=6), health education with oral rehydration solution (ORS) group (n=16), health education with metoprolol group (n=6), health education with midodrine group (n=5).The statistical analysis done by SPSS 16.0 package.Result:①The most common presenting symptoms of POTS are dizziness or light-headedness (66.66%) followed by chest tightness (30.30%), syncope (27.27%), headache (24.24%) and pallor (24.24%) respectively.②75.5% of children patients meet diagnostic criteria for POTS during 5 to 10 minute of HUTT.③There is significant statistic difference in heart rate between before and after treatment of total patients during 5 and 10 minute of HUTT (P<0.05).④The overall improvement found in 24(72.72%) patients whereas 9(27.27%) patients not respond to our treatment regimen.Conclusion:①The most common presenting symptom of POTS is dizziness or light-headedness.②Most of the patients meet diagnostic criteria for POTS during 5 to 10 minute duration of HUTT.③Health education, ORS, metoprolol and midodrine are effective in treatment of POTS and helpful to diminish the upright tachycardia. Whereas health education and health education with midodrine hydrochloride treatment method were more likely effective than health education with ORS and health education with metoprolol method.