The Postural Tachycardia Syndrome

Abstract

Postural tachycardia syndrome (POTS) is a disorder of unknown etiology, and patients with this condition exhibit orthostatic intolerance (OI) and excessive tachycardia. Excessive tachycardia with POTS has been defined as a rapid (within 10 minutes) increase in heart rate by more than 30 beats per minute or a heart rate that exceeds 120 beats per minute. Patients with POTS can experience difficulty with daily routines such as housework, shopping, eating, and attending work or school. The possibility exists that all forms of OI, including POTS, result from central hypovolemia even without tachycardia. The clinical findings of POTS are observed in an increasing number of patients who are usually female and aged 15 to 50 years. Adults with POTS do not have hypotension, whereas children may exhibit hypotension. Many patients with POTS are intolerant of exercise. "Idiopathic" POTS must be distinguished from other conditions that can reduce venous return to the heart and produce similar signs and symptoms such as dehydration, anemia, or hyperthyroidism. Therapies for POTS are directed at relieving the central hypovolemia or at compensating for the circulatory dysfunctions that may cause this disorder. Treatments have resulted in varying degrees of success and are often used in combination with each other.