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High Flow CFS/POTS
is characterized by normovolemia, peripheral vasodilation, and
increased peripheral blood flow, cardiac output and microvascular
filtration. Evidence indicates a mechanism of defective
adrenergic-mediated vasoconstriction associated with post-viral peripheral
neuropathy. Therefore, investigations of high flow POTS will not be
pursued further in the current proposal.
Normal Flow CFS/POTS
is characterized by normovolemia and
normal supine heart rate, peripheral resistance and blood flow. Upright,
splanchnic vascular regulation is abnormal producing venous pooling,
intense peripheral vasoconstriction and
acrocyanosis. Patients are often hyperflexible and may fulfill criteria
for the Ehlers-Danlos Syndrome.
Low Flow CFS/POTS
is characterized by mild hypovolemia and general decreased regional blood flows
related to defects in local blood flow regulation, most notable in the
dependent parts of the body and the cutaneous circulation. Peripheral
vasoconstriction decreases when upright. The phenotype is distinguished by
generalized pallor, cool skin, and often marked resting tachycardia.