#Pots symptoms checklist professional#

The presence of another condition that could explain the orthostatic tachycardia - such as anemia, anxiety, fever, pain, infection, dehydration, hyperthyroidism, pheochromocytoma, prolonged bed rest or the use of medications that can increase heart rate (including stimulants, diuretics and norepinephrine reuptake inhibitors) 9 - precludes the diagnosis of POTS.ĭiagnostic criteria for postural orthostatic tachycardia syndromeĪll of the following criteria must be met: Symptoms must occur after standing, with a marked increase in heart rate, but without a substantial drop in blood pressure.

The criteria for a diagnosis of POTS are listed in Box 2. 8 The consensus statements consistently require orthostatic tachycardia and symptomatic orthostatic intolerance to be chronic problems that coexist.

#Pots symptoms checklist professional#

Various professional societies in North America have published consensus criteria for the diagnosis of POTS, including the American Autonomic Society, 6 the Heart Rhythm Society, 7 the Canadian Cardiovascular Society 5 and, most recently, a POTS Working Group for the United States National Institutes of Health. 4 We discuss the diagnosis of POTS, conditions to consider in the differential diagnosis, associated disorders and the pharmacologic and nonpharmacologic management of patients with POTS, based on original research, narrative reviews and consensus statements ( Box 1). 1 – 3 The syndrome is more common in girls and young women and has been associated with other disorders, like migraine and Ehlers–Danlos syndrome. Patients may experience impaired quality of life and functional disability, which can be economically devastating. Patients describe lightheadedness and palpitations when upright, particularly when standing, which sometimes leads to syncope. The main characteristic of postural orthostatic tachycardia syndrome (POTS) is tachycardia when standing, without a drop in blood pressure. Treatments for POTS can improve symptoms and function, and can be initiated in primary care. Postural orthostatic tachycardia syndrome can lead to marked functional disability, often limiting work or schooling. Girls and women are more commonly affected with POTS, beginning in puberty and through early adulthood.

Patients with POTS have symptoms of orthostatic intolerance that improve with recumbence. Patients experience symptoms that are highly variable and multi-system in origin over the course of illness.Postural orthostatic tachycardia syndrome (POTS) is a chronic multisystem disorder the cardinal feature is orthostatic tachycardia. More than one-third of patients have a possible autoimmune or inflammatory trigger, including infection, concussion, or surgery/trauma. Over half of patients have joint hypermobility. Paediatric patients with postural orthostatic tachycardia syndrome seen in a large speciality clinic are predominantly female, are mostly Caucasian, have onset of symptoms in early adolescence, and have symptoms for over two years before diagnosis. Symptoms were largely cardiovascular, gastrointestinal, and neurological. Overall, 66% of patients subsequently had at least 10 symptoms, 50% had at least 14 symptoms, and 30% reported at least 26 symptoms. Six symptoms comprised 80% of initial patient complaints. Concurrent inflammatory disorders were noted in 5.2% of patients. Putative triggers included infection in 23.6% of patients, concussion in 11.4%, and surgery/trauma in 2.8%. Median duration of symptoms was 3.3 years with hypermobility versus 1.5 years without (p<0.00001). Median age of onset of symptoms was 12.6 years in patients with hypermobility versus 13.7 years in those without (p=0.0001). Joint hypermobility occurred in 57.3% of patients 22.4% had hypermobile Ehlers–Danlos syndrome and 34.9% had hypermobility spectrum disorder.

Caucasians were over-represented at 94.1% of patients. Female patients outnumbered males, 3.45:1. A total of 708 patients met the evaluation criteria.