TY - JOUR T1 - Orthodeoxia and postural orthostatic tachycardia in patients with pulmonary arteriovenous malformations: a prospective 8-year series JF - Thorax JO - Thorax SP - 1046 LP - 1047 DO - 10.1136/thoraxjnl-2014-205289 VL - 69 IS - 11 AU - V Santhirapala AU - B Chamali AU - H McKernan AU - H C Tighe AU - L C Williams AU - J T Springett AU - H R Bellenberg AU - A J Whitaker AU - C L Shovlin Y1 - 2014/11/01 UR - http://thorax.bmj.com/content/69/11/1046.abstract N2 - Postural changes in 258 patients with pulmonary arteriovenous malformations (PAVMs) reviewed between 2005 and 2013 were evaluated prospectively using validated pulse oximetry methods. Of the 257 completing the test, 75 (29%) demonstrated orthodeoxia with an oxygen saturation fall of at least 2% on standing. None described platypnoea (dyspnoea on standing). The heart rate was consistently higher in the erect posture: 74 (29%) had a postural orthostatic tachycardia of ≥20 min−1, and in 25 (10%) this exceeded 30 min−1. Orthostatic tachycardia was more pronounced in PAVM patients than controls without orthodeoxia (age-adjusted coefficient 5.5 (95% CIs 2.6, 8.4) min−1, p<0.001). For PAVM patients, the age-adjusted pulse rise was 0.79 min−1 greater for every 1% greater drop in oxygen saturation on standing (p<0.001). In contrast to the postural orthostatic tachycardia syndrome, in this population, there was a trend for more pronounced orthostatic tachycardia to be associated with better exercise tolerance. ER -