Thread by @MEActNet

One last thread on the #DysConf2018 by @rndNumGen. Hasan Abdallah of The Children's Heart Institute presented Sunday on "Stubborn POTS: Why won't my #POTS respond to treatment?" If treatment isn't effective after six months, it's important to dig deeper. (1/7)

@rndNumGen #POTS is a symptom complex rather than a disease entity in itself, with an underlying heterogenous pathophysiology. It has an unpredictable varying course, and the medical management paradigms is evolving. #DysConf2018 (2/7)

@rndNumGen To dig deeper, look at underlying pathophysiology. Look at medications that are being used--dosages, drug targets, interactions, etc. to see where you may be able to make changes. Look at comorbidities;they lead to more clinical severity and complex management. #DysConf2018 (3/7)

@rndNumGen Understand how comorbid diseases affect one another. For example, if you have #MCAS and #POTS, they can feed into each other: increased histamine can lead to increased sympathetic drive and vice versa. There can also be additional conditions you don't know of. #DysConf2018 (4/7)

@rndNumGen To try to better treat #POTS symptoms, look for immunological comorbidities and GI conditions such as Crohns, Ulcerative Colitis, and SIBO, and Gastroparesis. They are often missed and important to treat. #DysConf2018 (5/7)

@rndNumGen Doctors should also look for neurological comorbidities (Migraines, CSF Leak, Type 1 chiari, tethered spinal cord syndrome, History of TBIs) and sleep disorders (Insomnia, RLS, Hypersomnia, Narcolepsy, Obstructive Sleep apnea) when treating #POTS. #DysConf2018 (6/7)

@rndNumGen During the Q&A one person asked what Dr Abdallah though of a biotoxin exposure link with POTS. He responded by saying that most inflammatory reactions increase cytokines that affect blood vessels. Avoiding possible exposures is important. #DysConf2018 (7/7)