Cerebral Blood Flow, Heart Rate, and Blood Pressure Patterns during the Tilt Test in Common Orthostatic Syndromes

Figure 23

POTS + psychogenic unresponsiveness + syncope. The tilt provoked symptomatic excessive heart rate increment associated with a drop in CBFv without orthostatic hypotension which satisfies criteria for POTS. Then the patient became progressively less responsive which was consistent with pseudosyncope (psychogenic unresponsiveness) since CBFv was stable. The patient responded to reassurance and she regained consciousness later during the tilting. However, subsequently the patient experienced true mixed syncope at the 5th minute of the tilt (the tilt starts at minute 10.6 of the recording) and the tilt was terminated. Final diagnoses: (1) POTS; (2) psychogenic unresponsiveness; and (3) mixed syncope. Data from 21-year-old woman.