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- Postural tachycardia syndrome (POTS) is defined as orthostatic intolerance w/ an increase in heart rate by 30 bpm (or HR>120 bpm) that occurs within 10 mins of standing or upright tilt
- Orthostatic intolerance due to POTS will NOT cause orthostatic hypotension (defined as fall of >20/10 mm Hg on standing); instead patients may display no change, a small decline, or even a modest increase in blood pressure
- Symptoms include: palpitations, fatigue, lightheadedness, exercise intolerance, nausea, diminished concentration, tremulousness, and syncope
- POTS is a heterogeneous group of disorders with similar clinical manifestations
- Primary POTS - partial dysautonomia form
- Secondary POTS - hyperadrenergic form
- Tx varies according to the subtype/etiology of POTS and must be individualized
- *Caveat inappropriate sinus tachycardia (IST) and POTS are two different diagnosis where significant overlap exists, however thebtachycardia in IST is NOT postural
References
Grubb B. Postural Tachycardia Syndrome. Circulation 2008; 117:2814-2817