• 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  

1. Primary POTS - partial dysautonomia form
2. 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