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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

Fava GA, Magelli C, Savron G, Conti S, Bartolucci G, Grandi S, Semprini F, Saviotti FM, Belluardo P, Magnani B
Acta Psychiatr Scand 1994 May;89(5):314-9. doi: 10.1111/j.1600-0447.1994.tb01521.x. PMID: 8067269
Rimón R, Kampman R, Viukari M
Isr Ann Psychiatr Relat Discip 1979 Jun;17(2):144-8. PMID: 291588
OHSUZU H
Jpn Circ J 1963 Feb;27:206-9. doi: 10.1253/jcj.27.206. PMID: 13939695

Recent clinical studies

Etiology

Vaněček V, Tuček M, Ballegaard S
Cent Eur J Public Health 2017 Mar;25(1):64-66. doi: 10.21101/cejph.a4931. PMID: 28399357
Sonino N, Fava GA, Boscaro M, Fallo F
J Intern Med 1998 Dec;244(6):523-8. PMID: 9893106
Serlie AW, Erdman RA, Passchier J, Trijsburg RW, ten Cate FJ
Psychother Psychosom 1995;64(2):62-73. doi: 10.1159/000288993. PMID: 8559955
Fava GA, Magelli C, Savron G, Conti S, Bartolucci G, Grandi S, Semprini F, Saviotti FM, Belluardo P, Magnani B
Acta Psychiatr Scand 1994 May;89(5):314-9. doi: 10.1111/j.1600-0447.1994.tb01521.x. PMID: 8067269
Ehlers A, Breuer P
J Abnorm Psychol 1992 Aug;101(3):371-82. doi: 10.1037//0021-843x.101.3.371. PMID: 1500594

Diagnosis

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
Serlie AW, Erdman RA, Passchier J, Trijsburg RW, ten Cate FJ
Psychother Psychosom 1995;64(2):62-73. doi: 10.1159/000288993. PMID: 8559955
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
Morgan WP
Am Ind Hyg Assoc J 1983 Sep;44(9):685-9. doi: 10.1080/15298668391405562. PMID: 6356858
ADSETT CA, ROSS WD
Biochem Clin 1963;2:299-308. PMID: 14095780

Therapy

Fogari R, Zoppi A, Corradi L, Pasotti C, Malamani GD, Gradnik R, Bokor D, Gala C
Cardiovasc Drugs Ther 1992 Jun;6(3):249-53. doi: 10.1007/BF00051146. PMID: 1353368
Pelckmans MC, Verdickt W, Verberckmoes R, Van Boven M, Lissens W, Schurmans P, Daenens P
Acta Clin Belg 1983;38(6):397-400. doi: 10.1080/22953337.1983.11718968. PMID: 6673440
Theologides A
Am J Med 1982 Jul;73(1):1-3. doi: 10.1016/0002-9343(82)90910-x. PMID: 7091166
Silverman C
Am J Epidemiol 1973 Apr;97(4):219-24. doi: 10.1093/oxfordjournals.aje.a121502. PMID: 4577165
Bourne HR, Thomson PD, Melmon KL
Arch Intern Med 1970 Jun;125(6):1063-6. PMID: 4378135

Prognosis

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
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
Serlie AW, Erdman RA, Passchier J, Trijsburg RW, ten Cate FJ
Psychother Psychosom 1995;64(2):62-73. doi: 10.1159/000288993. PMID: 8559955
Fava GA, Magelli C, Savron G, Conti S, Bartolucci G, Grandi S, Semprini F, Saviotti FM, Belluardo P, Magnani B
Acta Psychiatr Scand 1994 May;89(5):314-9. doi: 10.1111/j.1600-0447.1994.tb01521.x. PMID: 8067269
Gatta A, Merkel C, Sacerdoti D, Angeli P
Ann Ital Med Int 1993 Oct-Dec;8(4):244-7. PMID: 8161481

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
Tsartsalis D, Dragioti E, Kontoangelos K, Pitsavos C, Sakkas P, Papadimitriou GN, Stefanadis C, Kallikazaros I
Psychiatriki 2016 Jul-Sep;27(3):192-203. doi: 10.22365/jpsych.2016.273.192. PMID: 27837573
Serlie AW, Erdman RA, Passchier J, Trijsburg RW, ten Cate FJ
Psychother Psychosom 1995;64(2):62-73. doi: 10.1159/000288993. PMID: 8559955
Fava GA, Magelli C, Savron G, Conti S, Bartolucci G, Grandi S, Semprini F, Saviotti FM, Belluardo P, Magnani B
Acta Psychiatr Scand 1994 May;89(5):314-9. doi: 10.1111/j.1600-0447.1994.tb01521.x. PMID: 8067269
Gatta A, Merkel C, Sacerdoti D, Angeli P
Ann Ital Med Int 1993 Oct-Dec;8(4):244-7. PMID: 8161481

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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