Postural Orthostatic Tachycardia Syndrome (POTS)

This article explains diagnostic criteria and symptoms of Postural Orthostatic Tachycardia Syndrome (POTS). The article is intended to serve as a tool for nurses to help patients with management of their condition. POTS is the most common form of dysautonomia, which is a catch all term for conditions arising from dysfunction of the ANS. The prevalence of POTS is hard to gauge, as there is significant lack of recognition and misdiagnosis around it resulting in an average time to diagnosis of 5 years. POTS is often comorbid with other conditions like hypermobility and MCAS, suggesting a possible underlying pathophysiology that connects them that still requires study. POTS cannot be diagnosed without the presence of the following symptoms: dizziness, light-headedness, brain fog, pre-syncope, chest pain or discomfort, headache, nausea, visual disturbances, fatigue, and tremulousness. A person meets criteria for POTS when they experience a sustained heart rate rise of greater than or equal to 30 bpm in adults and 40 bpm in children. While onset of the condition has a clear trigger in some individuals, such as long-COVID or after a concussion, but in others there is no clear trigger. Treating POTS is generally focused on alleviating symptoms, initially through lifestyle adjustments to improve blood volume and avoiding common triggers. Common triggers for POTS include hot environments, prolonged standing, or excess intake of diuretics like tea, coffee, or alcohol. The article argues that specialized roles should be developed to help with the treatment of dysautonomia and increase understanding and capacity for care.