Resolution of Postural Orthostatic Tachycardia Syndrome After CT-Guided, Percutaneous T2 Ethanol Ablation for Hyperhidrosis

Cardiovasc Intervent Radiol. 2016 Dec;39(12):1785-1788. doi: 10.1007/s00270-016-1455-6. Epub 2016 Aug 24.

Abstract

Postural orthostatic tachycardia syndrome is characterized by orthostatic intolerance. Orthostasis (or other mild physical stress) triggers a cascade of inappropriate tachycardia, lightheadedness, palpitations, and often fainting. The underlying defect is sympathetic dysregulation of the heart, which receives its sympathetic tone from the cervical and upper thoracic sympathetic ganglia. Primary hyperhidrosis is also thought to be the result of sympathetic dysregulation. We present the case of a patient treated with CT-guided, percutaneous T2 EtOH sympatholysis for craniofacial hyperhidrosis. The patient also suffered from postural orthostatic tachycardia syndrome for many years and was unresponsive to treatment. Immediately after sympatholysis, the patient experienced resolution of both craniofacial hyperhidrosis and postural orthostatic tachycardia syndrome.

Keywords: Autonomic dysregulation; Hyperhidrosis; POTS; Postural orthostatic tachycardia syndrome; Sympatholysis.

Publication types

  • Case Reports

MeSH terms

  • Ablation Techniques / methods*
  • Aged
  • Ethanol / administration & dosage*
  • Female
  • Humans
  • Hyperhidrosis / complications
  • Hyperhidrosis / therapy*
  • Postural Orthostatic Tachycardia Syndrome / complications
  • Postural Orthostatic Tachycardia Syndrome / therapy*
  • Radiography, Interventional / methods
  • Tomography, X-Ray Computed / methods*

Substances

  • Ethanol