Postural Orthostatic Tachycardia Syndrome (POTS): A Diagnostic Dilemma

Kamal Soliman; Steve Sturman; Prabodh K Sarkar; Atef Michael


Br J Cardiol. 2010;17(1):36-39. 

In This Article

Abstract and Introduction


Postural orthostatic tachycardia syndrome (POTS) is a condition that results from orthostatic intolerance. Patients, frequently young females, present with tachycardia, headache, palpitation, sweating, nausea and near syncope, on changing their posture from lying to standing. It is frequently misdiagnosed as panic attacks or anxiety neurosis. Tilt-table testing is diagnostic. Treatment depends on the type, whether primary or secondary, and there are non-pharmacological and pharmacological options.


Over the last few years, attention has been focused on a relatively new subgroup of disorders referred to as the postural orthostatic tachycardia syndrome (POTS). This syndrome includes a heterogeneous group of disorders that share the same characteristics.[1] POTS is characterised by orthostatic symptoms and dramatic increase in heart rate on standing, but does not involve orthostatic hypotension. Tilt-table testing has become the 'gold standard' for diagnosing this disorder. In primary care, many patients with POTS may be misdiagnosed as anxiety neurosis, and potential therapeutic opportunities may be missed. In this article, we present and discuss a case with POTS.


Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.
Post as: