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Neurocirculatory asthenia(ORSTI)

MedGen UID:
283928
Concept ID:
C1535893
Finding
Synonyms: IRRITABLE HEART; MITRAL VALVE PROLAPSE SYNDROME; Norepinephrine Transporter Deficiency; ORSTI; Orthostatic intolerance; SOLDIERS HEART
SNOMED CT: Orthostatic intolerance (870368003)
 
Gene (location): SLC6A2 (16q12.2)
 
Monarch Initiative: MONDO:0001315
OMIM®: 604715

Definition

A condition characterized by development of symptoms while standing. It is an autonomic nervous system disorder and the symptoms are relieved once the person sits back down. Symptoms include heart palpitations, sweating, anxiety, lightheadedness, hyperpnea, anxiety, and blurred vision. [from NCI]

Clinical features

From HPO
Elevated urinary norepinephrine level
MedGen UID:
1841548
Concept ID:
C5826344
Finding
The concentration of noradrenaline in the urine, normalized for urine concentration, is above the upper limit of normal.
Orthostatic tachycardia
MedGen UID:
866749
Concept ID:
C4021099
Finding
An increase in heart rate with standing of 30 beats per minute or more.

Professional guidelines

PubMed

Rimón R, Kampman R, Viukari M
Isr Ann Psychiatr Relat Discip 1979 Jun;17(2):144-8. PMID: 291588
LEVANDER-LINDGREN M
Acta Med Scand 1964 Jun;175:791-9. PMID: 14174797
OHSUZU H
Jpn Circ J 1963 Feb;27:206-9. doi: 10.1253/jcj.27.206. PMID: 13939695

Recent clinical studies

Etiology

Marker CD, Carmin CN, Ownby RL
Depress Anxiety 2008;25(10):824-31. doi: 10.1002/da.20348. PMID: 17597101Free PMC Article
Langs G, Quehenberger F, Fabisch K, Klug G, Fabisch H, Zapotoczky HG
J Affect Disord 2000 Apr;58(1):43-50. doi: 10.1016/s0165-0327(99)00097-x. PMID: 10760557
Serlie AW, Erdman RA, Passchier J, Trijsburg RW, ten Cate FJ
Psychother Psychosom 1995;64(2):62-73. doi: 10.1159/000288993. PMID: 8559955
Beitman BD, Mukerji V, Russell JL, Grafting M
J Psychiatr Res 1993;27 Suppl 1:35-46. doi: 10.1016/0022-3956(93)90016-u. PMID: 8145182
WHEELER EO, WHITE PD
J Am Med Assoc 1950 Mar 25;142(12):878-89. doi: 10.1001/jama.1950.02910300016005. PMID: 15410387

Diagnosis

Eifert GH
J Behav Ther Exp Psychiatry 1996 Jun;27(2):75-86. doi: 10.1016/0005-7916(96)00008-0. PMID: 8894906
Serlie AW, Erdman RA, Passchier J, Trijsburg RW, ten Cate FJ
Psychother Psychosom 1995;64(2):62-73. doi: 10.1159/000288993. PMID: 8559955
Tavel ME
Chest 1990 Jun;97(6):1285-8. doi: 10.1378/chest.97.6.1285. PMID: 2189694
Conti S, Savron G, Bartolucci G, Grandi S, Magelli C, Semprini F, Saviotti FM, Trombini G, Fava GA, Magnani B
Psychother Psychosom 1989;52(1-3):88-91. doi: 10.1159/000288304. PMID: 2486407
KEYES JW
JAMA 1965 Jun 14;192:951-5. doi: 10.1001/jama.1965.03080240021004. PMID: 14290433

Therapy

Klimes I, Mayou RA, Pearce MJ, Coles L, Fagg JR
Psychol Med 1990 Aug;20(3):605-11. doi: 10.1017/s0033291700017116. PMID: 2236369
Harron DW, Shanks RG
Eur Heart J 1985 Sep;6(9):722-9. doi: 10.1093/oxfordjournals.eurheartj.a061932. PMID: 2866961
Theologides A
Am J Med 1982 Jul;73(1):1-3. doi: 10.1016/0002-9343(82)90910-x. PMID: 7091166
Wolf E, Braun K, Stern S
Br Heart J 1974 Sep;36(9):872-9. doi: 10.1136/hrt.36.9.872. PMID: 4425601Free PMC Article
Silverman C
Am J Epidemiol 1973 Apr;97(4):219-24. doi: 10.1093/oxfordjournals.aje.a121502. PMID: 4577165

Prognosis

Sharif K, Watad A, Bragazzi NL, Lichtbroun M, Martini M, Perricone C, Amital H, Shoenfeld Y
Clin Rheumatol 2018 May;37(5):1161-1170. Epub 2018 Feb 7 doi: 10.1007/s10067-018-4009-2. PMID: 29417255
Langs G, Quehenberger F, Fabisch K, Klug G, Fabisch H, Zapotoczky HG
J Affect Disord 2000 Apr;58(1):43-50. doi: 10.1016/s0165-0327(99)00097-x. PMID: 10760557
Serlie AW, Erdman RA, Passchier J, Trijsburg RW, ten Cate FJ
Psychother Psychosom 1995;64(2):62-73. doi: 10.1159/000288993. PMID: 8559955
Beitman BD, Mukerji V, Russell JL, Grafting M
J Psychiatr Res 1993;27 Suppl 1:35-46. doi: 10.1016/0022-3956(93)90016-u. PMID: 8145182
WHEELER EO, WHITE PD
J Am Med Assoc 1950 Mar 25;142(12):878-89. doi: 10.1001/jama.1950.02910300016005. PMID: 15410387

Clinical prediction guides

Sharif K, Watad A, Bragazzi NL, Lichtbroun M, Martini M, Perricone C, Amital H, Shoenfeld Y
Clin Rheumatol 2018 May;37(5):1161-1170. Epub 2018 Feb 7 doi: 10.1007/s10067-018-4009-2. PMID: 29417255
Marker CD, Carmin CN, Ownby RL
Depress Anxiety 2008;25(10):824-31. doi: 10.1002/da.20348. PMID: 17597101Free PMC Article
Lange RT, Iverson GL, Sullivan K, Anderson D
J Clin Exp Neuropsychol 2006 Apr;28(3):294-305. doi: 10.1080/13803390490918156. PMID: 16618621
Langs G, Quehenberger F, Fabisch K, Klug G, Fabisch H, Zapotoczky HG
J Affect Disord 2000 Apr;58(1):43-50. doi: 10.1016/s0165-0327(99)00097-x. PMID: 10760557
Serlie AW, Erdman RA, Passchier J, Trijsburg RW, ten Cate FJ
Psychother Psychosom 1995;64(2):62-73. doi: 10.1159/000288993. PMID: 8559955

Recent systematic reviews

Borges GP, Tonon JHA, Zunini PAADS, Martins da Silva AS, Garcia MFV, de Azevedo-Marques Périco C, Lima DR, Torales J, Ventriglio A, Bhugra D, Castaldelli-Maia JM
Int Rev Psychiatry 2020 Aug-Sep;32(5-6):510-519. Epub 2020 May 27 doi: 10.1080/09540261.2020.1757925. PMID: 32459107

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