A tale of two syndromes: Lyme disease preceding postural orthostatic tachycardia syndrome

Ann Noninvasive Electrocardiol. 2015 Jan;20(1):82-6. doi: 10.1111/anec.12158. Epub 2014 May 15.


The pathogenesis of postural orthostatic tachycardia syndrome (POTS) is poorly understood. However, it has been suggested that altered immune activity or denervation of the autonomic system following illness may be an important trigger. Patients infected with Lyme disease have a small incidence of post-Lyme disease syndrome that share similar characteristics to POTS. We report a short series of two women who present with persistent symptoms of orthostatic intolerance consistent with POTS after treated Lyme disease.

Keywords: Lyme disease; postural orthostatic tachycardia syndrome.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Adult
  • Anti-Arrhythmia Agents / therapeutic use
  • Diet, Gluten-Free
  • Female
  • Fluid Therapy
  • Humans
  • Lyme Disease / complications*
  • Midodrine / therapeutic use
  • Postural Orthostatic Tachycardia Syndrome / complications*
  • Postural Orthostatic Tachycardia Syndrome / therapy*
  • Propranolol / therapeutic use
  • Sympathomimetics / therapeutic use
  • Syndrome


  • Anti-Arrhythmia Agents
  • Sympathomimetics
  • Midodrine
  • Propranolol