Case presentation A 32-year-old woman presented with a complaint of light-headedness and palpitations during the day. Her symptoms were most notable when she changed position (from a seated or prone position to a standing position). Medical history A few weeks before, she had an upper respiratory tract infection for which she took over-the-counter agents. One year before, she had been diagnosed with chronic fatigue syndrome.
Examination Office-based blood pressure in the following positions: Lying: 124/85 mmHg Sitting: 120/80 mmHg Standing: 114/78 mmHg Office-based heart rate in the following positions: Lying: 90 beats/min Sitting: 102 beats/min Standing: 120 beats/min Urine sodium excretion rate: 140 mmol/24 h Based on the examination, she was diagnosed with postural tachycardia syndrome . What is the most appropriate initial step for managing this patient? (Answer is posted in…
