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Syncope in an Athlete: a Case of Infectious Mononucleosis-Induced Postural Tachycardia Syndrome

Introduction More than 500,000 people in the United States, particularly young girls, experience chronic orthostatic intolerance resulting in substantial morbidity affecting work, school, and recreational activities (11,34). Up to a third of patients with postural tachycardia syndrome (POTS) have frank syncopal episodes with almost daily presyncope (21,29). Syncope accounts for approximately 1% of hospital admissions and 3% of emergency department visits with mortality and morbidity rates of over 7% (21,27). However, identifying the definitive etiology and mechanism of syncope and presyncope is fairly uncommon, and treatment and management can be frustrating because of the heterogeneous pathophysiologic basis of orthostatic tachycardia in POTS (3). This report will discuss a 21-year-old division I field hockey player with infectious mononucleosis (IM)induced POTS.