What are the symptoms of Postural Orthostatic Tachycardia Syndrome (POTS)?

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From the Guidelines

Postural Orthostatic Tachycardia Syndrome (POTS) symptoms primarily include an abnormal increase in heart rate when changing from a lying to standing position, often accompanied by lightheadedness, dizziness, and fainting, as well as fatigue, brain fog, exercise intolerance, headaches, nausea, and palpitations, as noted in the most recent study 1.

Symptoms of POTS

The symptoms of POTS can be diverse and vary widely among patients. Some common symptoms include:

  • Lightheadedness
  • Dizziness
  • Fainting
  • Fatigue
  • Brain fog
  • Exercise intolerance
  • Headaches
  • Nausea
  • Palpitations
  • Blurred vision
  • Tremors
  • Shortness of breath
  • Chest pain
  • Poor concentration These symptoms often worsen with heat exposure, after meals, during menstruation, and with dehydration, as discussed in 1 and 1.

Pathophysiology of POTS

The pathophysiology of POTS is complex and not fully understood, but it is believed to involve autonomic dysfunction, leading to an abnormal increase in heart rate when changing from a lying to standing position, as mentioned in 1. This autonomic dysfunction causes blood to pool in the lower extremities, reducing blood flow to the brain and other organs, and resulting in the characteristic symptoms of POTS.

Management of POTS

The management of POTS typically involves a combination of nonpharmacological and pharmacological interventions, as outlined in 1. Nonpharmacological interventions may include salt and fluid loading, elevation of the head of the bed, and use of support stockings. Pharmacological interventions may include low-dose beta-blockers, nondihydropyridine calcium-channel blockers, and ivabradine. The goal of treatment is to improve symptoms, increase exercise tolerance, and enhance quality of life.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

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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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