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In this presentation we will explore etiology, workup, and treatment of Postural Orthostatic Tachycardia Syndrome (POTS) beyond the conventional model. I will set the stage by introducing the various types of POTS and symptoms of each one as well as diagnostic workup and interpretation of autonomic testing and base-line treatments. From there I will address more commonly known etiologies and the pathophysiology of POTS including hypovolemia, deconditioning, neuroendocrine dysfunction, neuropathy and autoimmunity. I will expand this conventional model by discussing other underlying causes, co-morbidities, and sequelae including Mast Cell Activation Syndrome, Chronic Infections and exposures (Viruses including COVID, Mold and Mycotoxins, Lyme and Co-infections and Heavy metals), Clotting and blood flow dysregulations (including vascular compression syndromes), Structural conditions (hypermobility, Ehlers Danlos, Chiari malformation, cervical instability, tethered cord, intracranial hypertension/hypotension). As we discuss each of the above conditions, I will provide my clinical approach to work-up and treatment with a focus on chronic infections/exposures and blood flow.
Dr. Hearst is a licensed Naturopathic Physician in Washington State. She received her undergraduate degree in Molecular and Cellular Biology at the University of Puget Sound in Tacoma, WA, and earned her Doctoral degree in Naturopathic Medicine from Bastyr University in Kenmore, WA. After graduation, she completed two residencies, one with Dr Christine Schaffner at Immanence Health and the other with Drs. Michael Rak and Lily Stokely at One Connection Healthcare.
In her practice, she focuses on Dysautonomia with an emphasis on Postural Orthostatic Tachycardia Syndrome (POTS) and Orthostatic Hypotension (OH). She additionally sees patients with Connective Tissue and Structural Disorders [Hypermobility Spectrum Disorder (HSD), Hypermobile Ehlers-Danlos Syndrome, Chiari Malformation, Cervical Instability, Tethered Cord Syndrome, Intracranial Hypertension/Hypotension and Vascular Compression Disorders], Invisible Illnesses (Chronic Fatigue Syndrome/ME, Fibromyalgia, MCS), Immune and other Neurological Dysregulations [Mast Cell Activation Syndrome (MCAS), Histamine Intolerance and Small Fiber Neuropathy], Chronic Infections (Lyme Disease and co-infections, Mycotoxin/Mold Illness, post-COVID syndrome), Toxicology (Heavy Metal and Environmental toxicity), and Autoimmunity (Myasthenia Gravis, Hashimoto's, Sjogren's, Lupus, Rheumatoid Arthritis and Antiphospholipid Syndrome).
**This presentation is worth 1.75 Category 1 CE credits, including 0.5 Pharmacology credits for Washington NDs.**
Originally presented October 14, 2022, at WANP's CONNECT 2022 conference.