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Review
. 2020 May-Jun;63(3):263-270.
doi: 10.1016/j.pcad.2020.03.010. Epub 2020 Mar 25.

Postural Orthostatic Tachycardia Syndrome (POTS): A critical assessment

Brian Olshansky  1 , David Cannom  2 , Artur Fedorowski  3 , Julian Stewart  4 , Christopher Gibbons  5 , Richard Sutton  6 , Win-Kuang Shen  7 , James Muldowney  6 , Tae Hwan Chung  8 , Suzy Feigofsky  9 , Hemal Nayak  10 , Hugh Calkins  11 , David G Benditt  12
Affiliations
Review

Postural Orthostatic Tachycardia Syndrome (POTS): A critical assessment

Brian Olshansky et al. Prog Cardiovasc Dis. 2020 May-Jun.

Abstract

Although diagnostic criteria have been developed characterizing postural orthostatic tachycardia syndrome (POTS), no single set of criteria is universally accepted. Furthermore, there are gaps in the present criteria used to identify individuals who have this condition. The reproducibility of the physiological findings, the relationship of symptoms to physiological findings, the presence of symptoms alone without any physiological findings and the response to various interventions confuse rather than clarify this condition. As many disease entities can be confused with POTS, it becomes critical to identify what this syndrome is. What appears to be POTS may be an underlying condition that requires specific therapy. POTS is not simply orthostatic intolerance and symptoms or intermittent orthostatic tachycardia but the syndrome needs to be characterized over time and with reproducibility. Here we address critical issues regarding the pathophysiology and diagnosis of POTS in an attempt to arrive at a rational approach to categorize the syndrome with the hope that it may help both better identify individuals and better understand approaches to therapy.

Keywords: Orthostatic intolerance; Postural orthostatic tachycardia; Tachycardia.

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Figures

Fig. 1.
Fig. 1.
Proposed diagnostic flowchart in suspected POTS.
See this image and copyright information in PMC

Comment in

  • Special Assorted Topics 2021.
    Lavie CJ. Lavie CJ. Prog Cardiovasc Dis. 2021 Jul-Aug;67:1. doi: 10.1016/j.pcad.2021.07.011. Prog Cardiovasc Dis. 2021. PMID: 34412824 No abstract available.

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