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Syncope and POTS: Are Women Really Faint of Heart? 

Syncope and POTS: Are Women Really Faint of Heart?
Syncope and POTS: Are Women Really Faint of Heart?

Celina M. Yong

and Karen J. Friday

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date: 06 May 2021

Syncope (sometimes classified as neurally mediated syncope or orthostatic hypotension) and postural orthostatic tachycardia syndrome have distinct characteristics, but they share the common background physiology of orthostatic intolerance. Orthostatic intolerance may reflect a decreased central volume, altered volume distribution due to venous pooling, altered sympathetic outflow to maintain vascular tone, or altered vascular sensitivity to increased sympathetic tone. In symptomatic patients, several of these factors often combine to produce symptoms. Women generally experience these conditions more often than men. Many physiologic components may predispose women to acute or chronic orthostatic intolerance. Key factors in management are recognizing how limiting orthostatic intolerance can be and recognizing the patient’s frustration when the physiologic basis for these limitations is not appreciated by physicians, family, and peers.

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