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Antiphospholipid syndrome (APLS) is a multisystem autoimmune disorder that occurs when the immune system mistakenly produces antibodies that make the blood more likely to clot. As a result people with APLS are at increased risk of blood clots in the legs, kidneys, lungs, and brain.
Your doctor may ask these questions to check for this disease:
Medications to thin the blood and prevent clots are prescribed.
Reviewed By:
Kenji Taylor, MD, MSc (Family Medicine, Primary Care)
Dr. Taylor is a Japanese-African American physician who grew up and was educated in the United States but spent a considerable amount of time in Japan as a college student, working professional and now father of three. After graduating from Brown, he worked in finance first before attending medical school at Penn. He then completed a fellowship with the Centers for Disease Control before going on to specialize in Family and Community Medicine at the University of California, San Francisco (UCSF) where he was also a chief resident. After a faculty position at Stanford, he moved with his family to Japan where he continues to see families on a military base outside of Tokyo, teach Japanese residents and serve remotely as a medical director for Roots Community Health Center. He also enjoys editing and writing podcast summaries for Hippo Education.
Kaito Nakamura, MD (Rheumatology)
Dr. Nakamura is a rheumatologist who has practiced in the Ota Nishinouchi Hospital attached to Ota General Hospital, National Health Insurance Matsudo City Hospital, Chiba University Hospital, and the National Health Insurance Asahi Central Hospital.
Content updated on Mar 31, 2024
Following the Medical Content Editorial Policy
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With a free 3-min Antiphospholipid Syndrome quiz, powered by Ubie's AI and doctors, find possible causes of your symptoms.
This questionnaire is customized to your situation and symptoms, including the following personal information:
Biological Sex - helps us provide relevant suggestions for male vs. female conditions.
Age - adjusts our guidance based on any age-related health factors.
History - considers past illnesses, surgeries, family history, and lifestyle choices.
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Q.
POTS in Women: Managing Dizziness and Heart Rate Spikes
A.
POTS often affects women 15 to 50, causing dizziness and rapid heart rate on standing due to autonomic dysfunction, typically defined by a rise of at least 30 bpm without a significant blood pressure drop. Management focuses on fluids, salt, compression, slow position changes, heat avoidance, and graded recumbent exercise, with medications and evaluation for overlapping conditions used when needed. There are several factors to consider, including diagnosis, triggers, red flags, and when to seek urgent care; see below for complete details that could change your next steps.
References:
* Sheldon RS. Postural Orthostatic Tachycardia Syndrome and its Management: An Update. Curr Heart Fail Rep. 2023 Aug;20(4):255-260. doi: 10.1007/s11897-023-00624-9. Epub 2023 Jul 21. PMID: 37574765.
* Miller AJ, Dziwe N, Brar MS. Clinical Management of Postural Orthostatic Tachycardia Syndrome. J Cardiovasc Transl Res. 2023 Oct 12. doi: 10.1007/s12265-023-10431-7. Epub ahead of print. PMID: 37827284.
* Raj SR, Diedrich A. Postural Orthostatic Tachycardia Syndrome: A Concise Review of the Contemporary Diagnosis and Management. Card Electrophysiol Clin. 2022 Sep;14(3):477-488. doi: 10.1016/j.ccep.2022.05.004. Epub 2022 Aug 23. PMID: 35999298; PMCID: PMC9724108.
* Rigo-Bonnin R, Roldan-Figueroa I, Mirabet-Aguilar N, Delbón-Rojo A. Nonpharmacological management of postural orthostatic tachycardia syndrome: Current perspectives. Clin Auton Res. 2023 Oct;33(5):603-611. doi: 10.1007/s10286-023-00957-6. Epub 2023 Oct 2. PMID: 37780076.
* Goldstein DS, Raj SR, Grubb BP. Postural Orthostatic Tachycardia Syndrome (POTS): Mechanisms, Clinical Presentation, and Therapeutic Strategies. Circ Res. 2023 Jan 20;132(2):333-352. doi: 10.1161/CIRCRESAHA.122.321111. Epub 2023 Jan 12. PMID: 36639527; PMCID: PMC9861614.
Q.
Understanding POTS After 65: Stability and Fall Prevention
A.
POTS after 65 often brings dizziness, unsteadiness, palpitations, and fatigue on standing, raising fall risk through blood flow changes, deconditioning, and medication effects; key steps include slow position changes, steady hydration with clinician guided salt, compression, targeted strength and balance work, home safety updates, and a medical review to rule out other causes. There are several factors to consider, including red flag symptoms that need urgent care and individualized plans with your doctor; see the complete guidance below for practical checklists, medication considerations, and screening tools that could impact your next steps.
References:
* Fu, Q., & Vongpatanasin, W. (2021). Orthostatic Hypotension and Postural Orthostatic Tachycardia Syndrome in Older Adults: A Review. *Journal of Geriatric Cardiology*, *18*(9), 701–711.
* Vernino, S., & Raj, S. R. (2020). Management of Postural Orthostatic Tachycardia Syndrome in the Older Patient. *Current Geriatrics Reports*, *9*(4), 213–218.
* Tsuruoka, K., Nakashima, Y., & Fukae, J. (2017). Postural Orthostatic Tachycardia Syndrome in Older Adults: A Case Series. *Journal of the American Geriatrics Society*, *65*(7), 1599–1602.
* Okereke, R., Gopinath, B., Sue, C. M., & Sachdev, P. S. (2022). Falls in older adults with orthostatic intolerance: A systematic review and meta-analysis. *Age and Ageing*, *51*(6), afac123.
* Wang, W., & Wei, X. (2019). Autonomic Dysfunction in the Elderly. *Journal of Geriatric Cardiology*, *16*(6), 461–467.
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Link to full study:
https://www.medrxiv.org/content/10.1101/2024.08.29.24312810v1Sammaritano LR. Antiphospholipid syndrome. Best Pract Res Clin Rheumatol. 2020 Feb;34(1):101463. doi: 10.1016/j.berh.2019.101463. Epub 2019 Dec 19. PMID: 31866276.
https://www.sciencedirect.com/science/article/abs/pii/S1521694219301597?via%3DihubPetri M. Antiphospholipid syndrome. Transl Res. 2020 Nov;225:70-81. doi: 10.1016/j.trsl.2020.04.006. Epub 2020 May 12. PMID: 32413497; PMCID: PMC7487027.
https://www.translationalres.com/article/S1931-5244(20)30069-4/fulltextGarcia D, Erkan D. Diagnosis and Management of the Antiphospholipid Syndrome. N Engl J Med. 2018 May 24;378(21):2010-2021. doi: 10.1056/NEJMra1705454. PMID: 29791828.
https://www.nejm.org/doi/10.1056/NEJMra1705454Cervera R. Antiphospholipid syndrome. Thromb Res. 2017 Mar;151 Suppl 1:S43-S47. doi: 10.1016/S0049-3848(17)30066-X. PMID: 28262233.
https://www.thrombosisresearch.com/article/S0049-3848(17)30066-X/pdf