Postural Orthostatic Tachycardia Syndrome

Postural Orthostatic Tachycardia Syndrome (POTS) is a multifactorial disorder that is characterized by severe tachycardia and orthostatic intolerance that predominantly affects women during child-bearing ages.¹⁾

“POTS is defined as the presence of chronic symptoms of orthostatic intolerance (≥6 months) accompanied by an increased heart rate (HR) ≥30 bpm within 10 minutes of assuming an upright posture (Figure 1) and in the absence of orthostatic hypotension (blood pressure [BP] fall >20/10 mmHg).1,2 In children and adolescents, a higher threshold (≥40 bpm) should be used since they have a greater physiological orthostatic tachycardia.3 Morning postural assessments will optimize diagnostic sensitivity (at the expense of specificity) for POTS.4 The orthostatic tachycardia must occur in the absence of other overt causes of orthostatic tachycardia (e.g., acute blood loss), medications that impair autonomic regulation, or other chronic debilitating disorders that might cause tachycardia (e.g., anemia, diabetes with known autonomic neuropathy, systemic infectious or inflammatory conditions, hyperthyroidism).”²⁾

Unfortunately, prevalence of POTS may be difficult to determine globally since national trends of diagnostics categorize similar patients differently.