What is the MASA (Mathias-Rothschild-Alexander-Schneider) lean test for Postural Orthostatic Tachycardia Syndrome (POTS)?

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Last updated: May 12, 2025View editorial policy

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From the Guidelines

The Masa lean test is not a recommended or established method for diagnosing Postural Orthostatic Tachycardia Syndrome (POTS), and instead, an active standing test or tilt-table test should be used for diagnosis, as stated in the 2018 ESC guidelines for the diagnosis and management of syncope 1.

Diagnosis of POTS

To diagnose POTS, a healthcare professional typically uses an active standing test or a tilt-table test, which involves monitoring the patient's heart rate and blood pressure while standing or being tilted at an angle of at least 60 degrees 1.

  • The test is considered positive if the patient's heart rate increases by 30 beats per minute or more within 10 minutes of standing, without a significant drop in blood pressure.
  • The patient may also experience symptoms such as dizziness, lightheadedness, or palpitations during the test.
  • According to the European Heart Journal, POTS is characterized by an inappropriate heart rate increase without a concomitant blood pressure fall, likely due to severe deconditioning, immune-mediated processes, excessive venous pooling, and a hyperadrenergic state 1.

Importance of Proper Diagnosis

While the Masa lean test may be a simple at-home assessment, it is not a substitute for a formal medical diagnosis, which requires a thorough evaluation and management by a healthcare professional 1.

  • A proper diagnosis of POTS is essential to develop an effective treatment plan and to rule out other potential causes of symptoms.
  • The 2018 ESC guidelines emphasize the importance of accurate diagnosis and management of syncope, including POTS, to improve patient outcomes and reduce the risk of complications 1.

From the Research

Masa Lean Test for POTS

  • The Masa lean test is not directly mentioned in the provided studies as a diagnostic tool for Postural Orthostatic Tachycardia Syndrome (POTS) 2, 3, 4, 5, 6.
  • However, the studies discuss various diagnostic criteria and tests for POTS, including heart rate increase upon assuming an upright position 2, 3, 5.
  • The diagnosis of POTS typically involves a physical examination, medical history, and tests to rule out other conditions that may cause similar symptoms 3, 5.
  • Treatment for POTS often involves a combination of lifestyle modifications, medications, and other therapies, depending on the underlying pathophysiologic mechanisms and individual patient needs 2, 3, 4, 6.

Diagnostic Criteria for POTS

  • A heart rate increase of at least 30 beats per minute upon assuming an upright position, without orthostatic hypotension, is a key diagnostic criterion for POTS 2, 5.
  • Other symptoms, such as fatigue, exercise intolerance, and gastrointestinal distress, are also common in patients with POTS 3.
  • The studies emphasize the importance of individualizing treatment and management approaches for patients with POTS, given the heterogeneity of the condition and the variability in patient responses to different therapies 2, 3, 4, 6.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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