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Postural Orthostatic Tachycardia Syndrome : A State-of-the-Art Review

Lau, Dennis H. ; Fedorowski, Artur LU orcid ; Raj, Satish R. ; Schild, Caelum ; Pace, Laura A. ; Blitshteyn, Svetlana ; Raj, Vidya ; Boris, Jeffrey R. ; Kavi, Lesley and Seeley, Marie Claire , et al. (2026) In Heart Lung and Circulation
Abstract

Postural orthostatic tachycardia syndrome (POTS) is a complex disorder mainly of orthostatic intolerance, often accompanied by a spectrum of symptoms related to autonomic nervous system dysfunction. Although the diagnostic criteria require an orthostatic challenge test, the associated symptom burden can be broad and is often missed by treating healthcare professionals, resulting in significant diagnostic delay. Treatment of this highly heterogenous condition is nuanced and consists of non-pharmacologic and pharmacologic approaches. Availability of POTS care is limited, with a dearth of medical specialists or general practitioners specialising in autonomic medicine. The complexity of care for those with POTS necessitates a... (More)

Postural orthostatic tachycardia syndrome (POTS) is a complex disorder mainly of orthostatic intolerance, often accompanied by a spectrum of symptoms related to autonomic nervous system dysfunction. Although the diagnostic criteria require an orthostatic challenge test, the associated symptom burden can be broad and is often missed by treating healthcare professionals, resulting in significant diagnostic delay. Treatment of this highly heterogenous condition is nuanced and consists of non-pharmacologic and pharmacologic approaches. Availability of POTS care is limited, with a dearth of medical specialists or general practitioners specialising in autonomic medicine. The complexity of care for those with POTS necessitates a multidisciplinary approach due to the need for extended appointment times and frequent follow-ups to monitor therapeutic response and progress. This should include a primary team consisting of a general practitioner and trained autonomic physicians with specialist nurses, allied health professionals, and any other specialists required to manage the affected systems. This state-of-the-art review aims to cover the key aspects of diagnosing and managing POTS, including special neurological, gastroenterological, psychological, and paediatric considerations. There is an urgent need to provide services that meet the needs of the growing POTS population.

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organization
publishing date
type
Contribution to journal
publication status
epub
subject
keywords
Autonomic disorders, Chronic illness, Dysautonomia, Postural orthostatic tachycardia syndrome
in
Heart Lung and Circulation
publisher
Elsevier
external identifiers
  • scopus:105027218049
  • pmid:41519610
ISSN
1443-9506
DOI
10.1016/j.hlc.2025.09.004
language
English
LU publication?
yes
additional info
Publisher Copyright: © 2025 The Author(s)
id
89589532-bc23-40c2-a75c-da9eee9978a1
date added to LUP
2026-01-26 15:21:31
date last changed
2026-01-27 03:00:04
@article{89589532-bc23-40c2-a75c-da9eee9978a1,
  abstract     = {{<p>Postural orthostatic tachycardia syndrome (POTS) is a complex disorder mainly of orthostatic intolerance, often accompanied by a spectrum of symptoms related to autonomic nervous system dysfunction. Although the diagnostic criteria require an orthostatic challenge test, the associated symptom burden can be broad and is often missed by treating healthcare professionals, resulting in significant diagnostic delay. Treatment of this highly heterogenous condition is nuanced and consists of non-pharmacologic and pharmacologic approaches. Availability of POTS care is limited, with a dearth of medical specialists or general practitioners specialising in autonomic medicine. The complexity of care for those with POTS necessitates a multidisciplinary approach due to the need for extended appointment times and frequent follow-ups to monitor therapeutic response and progress. This should include a primary team consisting of a general practitioner and trained autonomic physicians with specialist nurses, allied health professionals, and any other specialists required to manage the affected systems. This state-of-the-art review aims to cover the key aspects of diagnosing and managing POTS, including special neurological, gastroenterological, psychological, and paediatric considerations. There is an urgent need to provide services that meet the needs of the growing POTS population.</p>}},
  author       = {{Lau, Dennis H. and Fedorowski, Artur and Raj, Satish R. and Schild, Caelum and Pace, Laura A. and Blitshteyn, Svetlana and Raj, Vidya and Boris, Jeffrey R. and Kavi, Lesley and Seeley, Marie Claire and Gallagher, Celine}},
  issn         = {{1443-9506}},
  keywords     = {{Autonomic disorders; Chronic illness; Dysautonomia; Postural orthostatic tachycardia syndrome}},
  language     = {{eng}},
  publisher    = {{Elsevier}},
  series       = {{Heart Lung and Circulation}},
  title        = {{Postural Orthostatic Tachycardia Syndrome : A State-of-the-Art Review}},
  url          = {{http://dx.doi.org/10.1016/j.hlc.2025.09.004}},
  doi          = {{10.1016/j.hlc.2025.09.004}},
  year         = {{2026}},
}