[Orthostatic intolerance--prevalence, diagnostic management and its significance for occupational medicine]

Orthostatic intolerance (OI) is a syndrome which is characterised by headache, concentration difficulties, palpitation of the heart, dizziness associated with postural tachycardia and plasma norepinephrine concentrations that are disportionately high in upright posture. OI hitherto can only be diagnosed by a tilt table examination with high expenditure. In this paper we examine the reliability and validity of a questionnaire as a screening instrument for OI.

We studied 138 young males (mean age 21.6 years) from the military service. After a medical check and filling in the questionnaire, the participants underwent a tilt table test. The questionnaire consisted of 10 items registering presence and frequency of typical OI-symptoms.

104 probands showed a normal tilt table test. OI was diagnosed in 14 probands, orthostatic hypotension (OH) in 6 and postural orthostatic tachycardia syndrome (POTS) in 14. The participants with OI scored significantly higher in the questionnaire than the normal subjects: The mean score of the OI group was 22.6, the normal participants had a mean score of 3.9. Participants with POTS had a mean score of 13.5 and subjects with OH had a mean score of 17.0.

We were able to establish a short questionnaire as a reliable and valid screening instrument for OI. Usage of this questionnaire can simplify enormously the diagnostic management of patients with suspected OI.