Propranolol in the treatment of orthostatic tacgycardia associated with orthostatic hypotension

Abstract A 53-year-old woman developed severe orthostatic tachycardia associated with idiopathic orthostatic hypotension. Her standing heart rates up to 140 beats per minute were associated with discomforting palpitation, lightheadedness, weakness, and chest pains; these symptoms persisted with the tachycardia even when the orthostatic hypotension was alleviated somewhat by administration of 9-alpha fluorohydrocortisone. Propranolol proved to be effective in slowing the orthostatic tachycardia and the patient's symptoms were markedly alleviated. It is concluded that beta blockade has a place in the treatment of orthostatic tachycardia complicating orthostatic hypotension.