Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2022 Mar 14;194(10):E378-E385.
doi: 10.1503/cmaj.211373.

Diagnosis and management of postural orthostatic tachycardia syndrome

Satish R Raj  1 , Artur Fedorowski  2 , Robert S Sheldon  2
Affiliations
Review

Diagnosis and management of postural orthostatic tachycardia syndrome

Satish R Raj et al. CMAJ. .
No abstract available

PubMed Disclaimer

Conflict of interest statement

Competing interests: Satish Raj receives research support from the Canadian Institutes of Health Research (grant MOP142426), Dysautonomia International and the Vanderbilt Institute for Clinical and Translational Research, funded by a Clinical and Translational Science Award from the National Center for Advancing Translational Sciences from the National Institutes of Health (UL1 TR000445). He reports consulting fees from Lundbeck, Theravance Biopharma and ArgenX BV, and payments and honoraria from Medscape, Spire Learning, Academy for Continued Healthcare Learning and Autonomic Neurosciences. He also reports payment for expert testimony from Faris Law, paid partipation on the data safety monitoring board for Arena Pharmaceuticals and unpaid participation on boards with the American Autonomic Society and the Canadian Cardiovascular Society Academy. Artur Fedorowski receives research support from Dysautonomia International. He reports consulting fees from ArgenX BV and payments and honoraria from Biotronick, Finapres Medical Systems and Bristol Myers Squibb. He also reports consulting fees, honoraria and participation on a data safety monitoring board with Medtronic. Robert Sheldon receives research support from the Canadian Institutes of Health Research and Dysautonomia International. He also reports 3 pending patents related to blood pressure monitoring and participation on a data safety monitoring board for a clinical trial on atrial fibrillation.

Figures

Figure 1:
Figure 1:
Proposed pathophysiological mechanisms for postural orthostatic tachycardia syndrome (POTS). The blue boxes indicate processes that may lead to reduced circulating blood volume, impaired venous return on standing and reflex orthostatic tachycardia. The red boxes indicate primary processes affecting sinus node response to orthostatic challenge and abnormal chronotropic response on standing. Different mechanisms may overlap. For example, autoantibodies that target cardiac receptors may produce an abnormal response during orthostasis, whereas those that target vascular receptors may lead to venous pooling, relative hypovolemia and reflex tachycardia on standing. Note: EDS = Ehlers–Danlos syndrome, MCAS = mast cell activation syndrome, RAAS = renin–angiotensin–aldosterone system.
See this image and copyright information in PMC

References

    1. Arnold A, Ng J, Raj SR. Postural tachycardia syndrome: diagnosis, physiology, and prognosis. Auton Neurosci 2018;215:3–11. - PMC - PubMed
    1. Bagai K, Song Y, Ling JF, et al. . Sleep disturbances and diminished quality of life in postural tachycardia syndrome. J Clin Sleep Med 2011;7:204–10. - PMC - PubMed
    1. Bourne KM, Chew DS, Stiles LE, et al. . Postural orthostatic tachycardia syndrome is associated with significant employment and economic loss. J Intern Med 2021;290:203–12. - PMC - PubMed
    1. Shaw BH, Stiles LE, Bourne K, et al. . The face of postural tachycardia syndrome: insights from a large cross-sectional online community-based survey. J Intern Med 2019;286:438–48. - PMC - PubMed
    1. Raj SR, Guzman JC, Harvey P, et al. . Canadian Cardiovascular Society position statement on postural orthostatic tachycardia syndrome (POTS) and related disorders of chronic orthostatic intolerance. Can J Cardiol 2020;36:357–72. - PubMed

Publication types

MeSH terms