A Case of Orthostatic Tachycardia Syndrome Presenting with Panic Attack during Tilt Table Testing

Publisher: Karger

E-ISSN: 1421-9751|120|2|91-94

ISSN: 0008-6312

Source: Cardiology, Vol.120, Iss.2, 2011-12, pp. : 91-94

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Abstract

A 26-year-old woman experienced syncope on standing 2–3 times a year for more than 15 years. The attack was typically associated with palpitations and frequently accompanied by a feeling of intense fear. The patient underwent head-up tilt table testing at 70°for 40 min to determine the cause of the syncope. The tilt test results suggested that the etiology of the syncope was orthostatic tachycardia syndrome complicated by panic attack-associated hypocapnic hyperventilation, which presumably caused a greater degree of deep cerebral hypoperfusion than would be expected with orthostatic tachycardia syndrome alone, ultimately leading to the patient’s symptoms, including syncope. In conclusion, monitoring the ventilation and/or arterial CO2 level during head-up tilt table testing is occasionally required when evaluating patients with postural syncope.