Postural Tachycardia Syndrome

presence?.- Can we treat it empirically without immunology review.- When to refer.- Audiovestibular medicine.- Recognising vertiginous contributions (migraine variant balance disorder).- When to refer and what to expect.- Part IV - Relevant Diagnostic Considerations.- Potential alternative causes.- Metabolic issues.- Lyme disease.- Chronic Fatigue syndrome.- Part V - Therapy.- Treatment.- Non-pharmacological - salt, fluid, compression.- Non-pharmacological - exercise.- Pharmacological - when and how to use it.- Midodrine.- Ivabradine.- Betablockers.- Fludrocortisone.- Octreotide.- Pyridostigmine.- Clonidine.- Others e.g. desmopressin, EPO, SSRI, IV fluid.- Assessing benefit.- Part VI - Relevant Therapeutic Associations .- Obstetrics / Gynaecology.- Are there links with endometriosis and PCOS?.- Who should be referred and when?.- Implications for pregnancy and its management.- Pelvic floor issues.- Anaesthetic management.- Anaesthetic considerations in POTS / EDS.- Respiratory medicine .- Hyperventilation is common - why and how to recognise it; why does it occur.- What clinical findings / tests can exclude other conditions.- When to refer to respiratory physio'.- What management can help hyperventilation.- When to consider respiratory medicine review.- Psychological contributors.- Functional symptoms.- Stress responses.- When to involve a psychologist / psychiatrist.- CBT and other therapies.- Part VII - Service Models.- Primary Care.- When to consider referral.- Pointers in the surgery to the diagnosis.- Tests to do first.- Challenges of referral.- Shared-care arrangements.- POTS clinics.- UK models of care KCH, NHNN, Sheffield, Newcastle, William Harvey, Royal Brompton, St Mary's, Poole.- Can you set up your own autonomic tests and how do you do it?.- Nursing aspects.- Developing a nurse led clinic.- Nurse-led follow-up.- Patient aspects.- POTS-UK / STARS.- EDS UK / International HMSA.