Keywords

Postural orthostatic tachycardia syndrome (POTS), autonomic dysautonomia, orthostatic intolerance, non-neurogenic seizure

Abstract

Postural orthostatic tachycardia syndrome (POTS) is a form of orthostatic intolerance (OI) that affects 0.2% of the population and is over-represented in women of childbearing age. It is caused by autonomic dysfunction and hypovolemia that presents with marked tachycardia and with minimal change in blood pressure upon standing. Orthostatic symptoms must be present including: lightheadedness, nausea, chest pain, palpitations, shortness of breath, and nausea and must improve with recumbence. The three main subtypes of POTS are neuropathic POTS associated destruction of peripheral nerves and venous pooling, hypovolemic POTS associated with low blood volume, and hyperadrenergic POTS associated with inappropriate sympathetic activation. It is easily diagnosed by hemodynamic testing, but is difficult to treat. Treatment involves increased fluid and salt intake, exercise, and pharmacologic measures. POTS is a chronic illness that significantly affects quality of life. The purpose of this article is to describe the clinical presentation, the underlying physiological and pathological processes involved, the diagnostic criteria, and current management strategies for postural orthostatic tachycardia syndrome (POTS). Keywords: