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What Are We Treating? : The Need for Broader Provider Understanding of POTS, Its Nature, and Care

Reyes, Jorge L ; Fedorowski, Artur LU orcid ; Deering, Thomas ; Grubb, Blair ; Kenny, Rose Anne ; Lim, P Boon ; Olshansky, Brian ; Sandroni, Paolo ; Raj, Satish R and Sheldon, Robert S , et al. (2026) In The American journal of medicine
Abstract

Postural orthostatic tachycardia syndrome (POTS) as conventionally defined is a chronic condition (typically >3 months duration) incorporating reproducible symptoms of orthostatic intolerance (including dizziness/lightheadedness, and near-syncope) in the absence of orthostatic hypotension (i.e., absence of a sustained systolic blood pressure drop >20mmHg with upright posture).
1-10 More recently, however, the 'POTS' landscape as applied by many clinicians has broadened; the term 'POTS' has become increasingly used to categorize a multisystem disorder the underlying etiologies of which remain unclear but may include autonomic dysfunction and/or autoimmune disorders; as such the clinical picture has evolved to encompass a wide... (More)

Postural orthostatic tachycardia syndrome (POTS) as conventionally defined is a chronic condition (typically >3 months duration) incorporating reproducible symptoms of orthostatic intolerance (including dizziness/lightheadedness, and near-syncope) in the absence of orthostatic hypotension (i.e., absence of a sustained systolic blood pressure drop >20mmHg with upright posture).
1-10 More recently, however, the 'POTS' landscape as applied by many clinicians has broadened; the term 'POTS' has become increasingly used to categorize a multisystem disorder the underlying etiologies of which remain unclear but may include autonomic dysfunction and/or autoimmune disorders; as such the clinical picture has evolved to encompass a wide range of non-cardiovascular symptoms such as persistent exertional intolerance, fatigue, 'brain fog', thermo-regulatory disorders, and various gastrointestinal symptoms including gastroparesis and certain food intolerance reactions. Thus, while cardiovascular disorders may be the principal manifestation of presumed 'POTS' in many patients, disturbances in a variety of body systems may dominate the clinical presentation in others. This communication, derived from a diverse group of practitioners who care for the wide range of patients often referred for 'suspected POTS', offer the view that optimizing diagnostic evaluation and subsequent care of these individuals necessitates a broad range of clinical skills; in essence involvement of a 'village' of dedicated multi-talented care providers.

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Contribution to journal
publication status
epub
subject
in
The American journal of medicine
publisher
Elsevier
external identifiers
  • pmid:42248496
ISSN
0002-9343
DOI
10.1016/j.amjmed.2026.05.042
language
English
LU publication?
no
additional info
Copyright © 2026. Published by Elsevier Inc.
id
2be383ac-8ca6-48da-8b16-452e48d5724f
date added to LUP
2026-06-08 15:15:51
date last changed
2026-06-09 15:26:02
@article{2be383ac-8ca6-48da-8b16-452e48d5724f,
  abstract     = {{<p>Postural orthostatic tachycardia syndrome (POTS) as conventionally defined is a chronic condition (typically &gt;3 months duration) incorporating reproducible symptoms of orthostatic intolerance (including dizziness/lightheadedness, and near-syncope) in the absence of orthostatic hypotension (i.e., absence of a sustained systolic blood pressure drop &gt;20mmHg with upright posture). <br>
 1-10 More recently, however, the 'POTS' landscape as applied by many clinicians has broadened; the term 'POTS' has become increasingly used to categorize a multisystem disorder the underlying etiologies of which remain unclear but may include autonomic dysfunction and/or autoimmune disorders; as such the clinical picture has evolved to encompass a wide range of non-cardiovascular symptoms such as persistent exertional intolerance, fatigue, 'brain fog', thermo-regulatory disorders, and various gastrointestinal symptoms including gastroparesis and certain food intolerance reactions. Thus, while cardiovascular disorders may be the principal manifestation of presumed 'POTS' in many patients, disturbances in a variety of body systems may dominate the clinical presentation in others. This communication, derived from a diverse group of practitioners who care for the wide range of patients often referred for 'suspected POTS', offer the view that optimizing diagnostic evaluation and subsequent care of these individuals necessitates a broad range of clinical skills; in essence involvement of a 'village' of dedicated multi-talented care providers.<br>
 </p>}},
  author       = {{Reyes, Jorge L and Fedorowski, Artur and Deering, Thomas and Grubb, Blair and Kenny, Rose Anne and Lim, P Boon and Olshansky, Brian and Sandroni, Paolo and Raj, Satish R and Sheldon, Robert S and Stewart, Julian and Sutton, Richard and Benditt, David G}},
  issn         = {{0002-9343}},
  language     = {{eng}},
  month        = {{06}},
  publisher    = {{Elsevier}},
  series       = {{The American journal of medicine}},
  title        = {{What Are We Treating? : The Need for Broader Provider Understanding of POTS, Its Nature, and Care}},
  url          = {{http://dx.doi.org/10.1016/j.amjmed.2026.05.042}},
  doi          = {{10.1016/j.amjmed.2026.05.042}},
  year         = {{2026}},
}