Materiały źródłowe

• #1 Postural Orthostatic Tachycardia Syndrome – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK541074/

  Postural orthostatic tachycardia syndrome (POTS) is a common form of autonomic dysregulation characterized as an excessive tachycardia upon standing in the presence of orthostatic intolerance. […] As one of the most common forms of orthostatic intolerance globally, postural orthostatic tachycardia syndrome is estimated to affect over 500000 patients in the United States alone. […] Worldwide prevalence has not been well-established, although previous study populations have estimated ranges between 0.2 to 1% in developed countries. […] The overwhelmingly demographic of POTS patients are young, premenopausal Caucasian females (4.5 to 1) between the ages of 15 and 45 years old, with the majority presenting between the ages of 15 and 25 years. […] There is a significant overlap between POTS, chronic fatigue syndrome and across a spectrum of autoimmune disorders.

• #1 Dysautonomia International: Postural Orthostatic Tachycardia Syndrome

  https://www.dysautonomiainternational.org/page.php?ID=30

  Postural orthostatic tachycardia syndrome (POTS) is a common autonomic nervous system disorder characterized by an excessively fast heart rate and symptoms of lightheadedness upon standing. […] Prior to the COVID-19 pandemic, POTS was estimated to impact 1-3 million Americans, and millions of other people around the world. Experts estimate that the POTS population has doubled since the start of the COVID-19 pandemic.

• #1 Postural orthostatic tachycardia syndrome – Wikipedia

  https://en.wikipedia.org/wiki/Postural_orthostatic_tachycardia_syndrome

  Postural orthostatic tachycardia syndrome (POTS) is a condition characterized by an abnormally large increase in heart rate upon sitting up or standing. POTS is more common in women than men, with a female-to-male ratio of 4:1. The prevalence of POTS is unknown. One study estimated a minimal rate of 170 POTS cases per 100,000 individuals, but the true prevalence is likely higher due to underdiagnosis. Another study estimated that there are at least 500,000 cases in the United States. Most people with POTS are aged between 20 and 40, with an average onset of 21. Diagnoses of POTS beyond age 40 are rare, perhaps because symptoms improve with age. […] It is estimated that 13 million people in the United States have POTS.

• #1 Understanding and Managing Postural Orthostatic Tachycardia Syndrome

  https://www.uspharmacist.com/article/understanding-and-managing-postural-orthostatic-tachycardia-syndrome

  POTS affects anywhere from 1 million to 3 million people in the United States. Reports suggest that women aged 15 to 50 years are more commonly diagnosed with POTS. This condition is characterized by poor blood circulation to the heart when the patient stands up from a supine position. POTS is often misdiagnosed, owing to limited research and training of clinicians about this underappreciated condition. […] It is especially important that clinicians understand the diagnosis and treatment of this syndrome, as it has been triggered by bacterial and viral infections. In fact, researchers have identified a potential association between COVID-19 and POTS. Several case reports have been published in which patients who recovered from COVID-19 continued to experience POTS-like symptoms, including fatigue and lightheadedness. More than 246 million COVID-19 cases have been reported globally, and although few case reports on COVID-associated POTS have been published, the number of people affected by postCOVID-19 POTS is expected to grow as more patients worldwide become infected with severe acute respiratory syndrome coronavirus 2.

• #1 Frontiers | Postural orthostatic tachycardia syndrome and other related dysautonomic disorders after SARS-CoV-2 infection and after COVID-19 messenger RNA vaccination

  https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2023.1221518/full

  It is estimated that 2.15–6.45 million people across the world have suffered from post–COVID-19 dysautonomia. […] In a recent systematic review of cardiovascular autonomic dysfunction and COVID-19, POTS was the most frequent diagnosis in individuals with post–COVID-19 orthostatic complaints. […] The timing of POTS symptom onset was concurrent with usual acute COVID-19 symptoms, but it may occur months after infection. […] The socioeconomic impact of symptom persistence after COVID-19 infection is due to autonomic and neurohemodynamic involvement, revealing the need for early intervention. Better recognition of autonomic dysfunction could reduce morbidity and socioeconomic impact.

• #1 Overview of Postural Orthostatic Tachycardia Syndrome (POTS) for General Cardiologists – ScienceOpen

  https://www.scienceopen.com/hosted-document?doi=10.15212/CVIA.2023.0098

  The natural history of POTS is not well studied. POTS can be precipitated by several immunological stressors, including viral infection, menarche, physical trauma, pregnancy, and surgery. The recent COVID-19 pandemic might have influenced the incidence of POTS, because as many as one-third of highly symptomatic patients with long-COVID meet the diagnostic criteria for POTS. […] In one survey of 94 patients, 24% were disabled and unable to work because of POTS. […] Recent data suggest that POTS is the most common autonomic disorder after COVID-19. In one report, 2%–14% of COVID-19 survivors developed POTS within 6–8 months after infection. The predominant symptoms were tachycardia and palpitations. The proposed pathophysiology is the production of autoantibodies after infection with SARS-CoV-2, the coronavirus causing COVID-19, which in turn activate the sympathetic system and cause autonomic dysregulation and tachycardia. The risk of POTS is also elevated after COVID-19 vaccination, but this risk is lower than the risk of POTS after COVID-19 infection.

• #1 Postural Orthostatic Tachycardia Syndrome

  https://elsevier.health/en-US/preview/postural-orthostatic-tachycardia-syndrome-co

  Postural orthostatic tachycardia syndrome primarily affects females of childbearing age. […] The female:male ratio is more than 5:1. […] The reason for the strong female predominance in postural orthostatic tachycardia syndrome is not known. […] A large online patient-community survey of self-reported postural orthostatic tachycardia syndrome patients found that most initially present with symptoms in adolescence and early adulthood. […] The most common age of symptom onset was 14 years with a median age of 17 years, and 50% of patients had symptom onset before 18 years of age. […] The natural history of postural orthostatic tachycardia syndrome is not clear, but it does not appear to increase the risk of mortality.

• #1 Postural Orthostatic Tachycardia Syndrome (PoTS Syndrome)

  https://patient.info/doctor/postural-tachycardia-syndrome-pots-pro

  PoTS is the most common form of orthostatic intolerance in young people, typically affecting young women. […] The prevalence of PoTS syndrome in the UK is estimated to be 2 in 1,000. It is a diagnosis which is thought to be missed frequently. It is five times as common in women as it is in men. It can occur at any age but is most common between the ages of 15 and 50. […] Prognosis depends on the type and the underlying cause. It is better in younger people. 80% of developmental PoTS symptoms resolve within a few years. Those cases which follow viral infections tend to resolve spontaneously within a few years. 90% respond to some form of treatment. PoTS syndrome may cause significant reduction in quality of life and may lead to anxiety and depression.

• #1 Postural orthostatic tachycardia syndrome | MedLink Neurology

  https://www.medlink.com/articles/postural-orthostatic-tachycardia-syndrome

  Onset frequently occurs following pregnancy, major surgery or trauma, or presumed viral illness. […] A smaller proportion (10% to 15%) has a family history of orthostatic intolerance. […] There is a strong association between POTS and joint hypermobility or Ehlers-Danlos syndrome. […] In adolescents, over half have joint hypermobility (either Ehlers-Danlos syndrome or hypermobility spectrum disorder), and more than one third have a putative autoimmune or inflammatory trigger including infection, surgery, or trauma. […] However, the purported association of these entities stems from an overlapping pool of vague, subjective symptoms, which is inadequate evidence to conclude that any such relationship exists. […] Anecdotal reports of POTS onset following COVID-19 infection or less commonly following vaccination for COVID-19 infection or improvement in POTS following COVID-19 infection do not by themselves establish a causal association.

• #1 Postural Orthostatic Tachycardia Syndrome (POTS) – Causes, Symptoms, Diagnosis, Treatment and Prognosis

  https://www.medindia.net/health/conditions/postural-orthostatic-tachycardia-syndrome.htm

  Postural Orthostatic Tachycardia Syndrome (POTS) can occur at any age, sex or race. […] It primarily affects females in the age-group 15-50 years. Approximately 80% of females are affected. The remaining 20% include males, including both men and boys. Therefore, the female to male ratio is 5:1. POTS can be precipitated by stressful conditions like sepsis, pregnancy, surgery or trauma. The prevalence of POTS is approximately 170/100,000 population. The mean age of onset in adults is approximately 30 years and ranges between the ages of 20-40 years.

• #1 Postural Orthostatic Tachycardia Syndrome

  https://practicalneurology.com/diseases-diagnoses/alzheimer-disease-dementias/postural-orthostatic-tachycardia-syndrome/31643/

  POTS is a cause of dizziness, fatigue, cognitive dysfunction, and headaches that can significantly contribute to poor quality of life. […] The prevalence of POTS is likely unknown, but current epidemiologic studies suggest that up to 1% of the US population may be affected. Onset is often between age 15 to 25 years, and more than 75% are in girls and women. […] In approximately 12.5% of cases, there is a family history of POTS symptoms, suggesting a genetic contribution to the disorder. […] The diagnosis of POTS, which is clinical and does not require ancillary testing, should be considered in individuals presenting with these symptoms.

• #1 POTS: Causes, Symptoms, Diagnosis & Treatment

  https://my.clevelandclinic.org/health/diseases/16560-postural-orthostatic-tachycardia-syndrome-pots

  Postural orthostatic tachycardia syndrome (POTS) is a condition that causes a number of symptoms when you transition from lying down to standing up, such as a fast heart rate, dizziness and fatigue. […] POTS is common. It affects about 1 to 3 million people in the United States. […] The majority of people with POTS are women aged 15 to 50 years. But men can also have POTS. […] People who have certain autoimmune conditions, such as Sjogrens syndrome, lupus and celiac disease, are also more likely to develop POTS. […] Each case of POTS is different. People with POTS may see symptoms come and go over a period of years. In most cases, with adjustments in diet, medications and physical activity, a person with POTS will experience an improvement in their quality of life. […] The prognosis (outlook) for POTS is generally good, although it can severely disrupt daily living. POTS symptoms may come and go for years. In approximately 80% of cases, the condition improves, but many people have residual symptoms. […] The biggest risk to people with POTS is getting hurt if they faint and fall. […] People with POTS have a normal life expectancy. The condition doesnt decrease life expectancy.

• #1 Postural orthostatic tachycardia syndrome – Symptoms, diagnosis and treatment | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/3000308

  Postural orthostatic tachycardia syndrome (POTS) is a clinical syndrome characterised by symptoms of orthostatic intolerance and an increase in heart rate (without orthostatic hypotension) on standing, in the absence of other causes. […] It is also associated with comorbidities such as migraine headaches, irritable bowel syndrome, Ehlers-Danlos syndrome, chronic fatigue syndrome, and autoimmune diseases such as Hashimoto’s thyroiditis and coeliac disease. […] There is a lack of evidence for effective treatments for POTS in children. […] However, it is reasonable to treat children with the same interventions that are recommended for adults, with a focus on promoting salt and fluid intake, physical counterpressure techniques, and reassurance to the patient and their families. […] POTS is a chronic, multi-system disorder that is thought to be due to an autoimmune process.

• #1 Forms of Dysautonomia – Dysautonomia Support Network

  https://www.dysautonomiasupport.org/forms-of-dysautonomia/

  Postural Orthostatic Tachycardia Syndrome (POTS) is one of the more common forms of dysautonomia. The key features of POTS are a sustained increased heart rate upon standing and orthostatic intolerance symptoms. However, people with POTS also experience symptoms regardless of position. […] It is estimated that between 500,000 – 3 million Americans have POTS. More than 75% with POTS are female, and the average age of onset is between 15 and 25 years of age. […] Researchers have found that POTS commonly occurs with other conditions such as chronic fatigue syndrome, small fiber neuropathy, mast cell activation disorder, hypermobile Ehlers-Danlos syndrome, migraines, gastrointestinal dysfunction (e.g. irritable bowel syndrome), autoimmune disorders, and fibromyalgia. […] The main POTS subtypes are Hyperadrenergic POTS, Neuropathic POTS, Hypovolemic POTS, and immune-mediated or autoimmune POTS.

• #1 Postural Tachycardia Syndrome (POTS) Diagnosis and Treatment: Basics and New Developments

  https://www.acc.org/Latest-in-Cardiology/Articles/2016/01/25/14/01/Postural-Tachycardia-Syndrome-POTS-Diagnosis-and-Treatment-Basics-and-New-Developments

  Postural Tachycardia Syndrome (POTS) Diagnosis and Treatment: Basics and New Developments […] The overwhelming majority of patients with POTS are women (80-85%) of child-bearing age (13-50 years). […] Multiple studies have documented low health related quality of life in patients with POTS, with scores comparable to those seen in patients with congestive heart failure. […] POTS can produce substantial disability among previously healthy people. Patients with POTS demonstrate a HR increase of 30 bpm (40 bpm in children) within 10 min of standing, are often hyperadrenergic, and are quite symptomatic. […] The focus of therapy should be an exercise reconditioning program, including both aerobic and resistance training, with an emphasis on non-upright exercises such as rowing machines, recumbent cycles and swimming.

• #1 The POTS (Postural Tachycardia Syndrome) Epidemic: Hydration and Nutrition Issues – Practical Gastro

  https://practicalgastro.com/2019/10/14/the-pots-postural-tachycardia-syndrome-epidemic-hydration-and-nutrition-issues/

  Patients who have an antecedent event (e.g., viral illness) and a more acute onset seem to do better, while those without an antecedent event are more likely to have a family history of similar symptoms and a less favorable outcome. […] The purpose of this review is to increase the awareness of this condition to clinical nutrition specialists who are increasingly being referred these complex patients. […] In this review, we will focus on a discussion of symptoms and conditions associated with POTS and provide an overview of its management including the potential need for nutrition and hydration support.

• #1 Understanding and Managing Postural Orthostatic Tachycardia Syndrome

  https://www.uspharmacist.com/article/understanding-and-managing-postural-orthostatic-tachycardia-syndrome

  Postural orthostatic tachycardia syndrome (POTS) is a disorder of the autonomic nervous system (ANS) characterized by cardiac and neurologic symptoms that occur upon standing. Patients with POTS are routinely dismissed with inaccurate diagnoses by physicians who are unfamiliar with this syndrome. In fact, results from a survey conducted in more than 700 patients indicated challenges in obtaining the correct diagnosis, with more than 69% of patients being inappropriately diagnosed with an anxiety disorder rather than POTS. Although POTS affects both men and women, the literature suggests that the typical demographic diagnosed with POTS is premenopausal Caucasian women. It is imperative that clinicians familiarize themselves with POTS, as the number of cases has been growing since the onset of the coronavirus disease 2019 (COVID-19) pandemic. This has led to increased efforts by scientists and clinicians to better understand this syndrome and its connection to COVID-19.

• #1 Postural Orthostatic Tachycardia Syndrome

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7046364/

  The term postural orthostatic tachycardia syndrome (POTS) was first used by a team of researchers from Mayo Clinic led by neurologist Philip Low, in 1993. However, the disorder was not new; over the last 160 years, it has been known by many different names, such as neurocirculatory asthenia, orthostatic tachycardia, and orthostatic intolerance. Patients with POTS can be misdiagnosed as having severe anxiety, panic disorder, or chronic fatigue syndrome, because of their similar clinical features. […] The prevalence of POTS is around 0.2% in the general population, and an estimated 500,000 to 1,000,000 individuals in the United States have the disorder. Postural orthostatic tachycardia syndrome can affect individuals of either sex at any age, but 75% to 80% are female, and most patients are between the ages of 15 and 25 years at diagnosis.

• #1 Observational case series of postural tachycardia syndrome (PoTS) in post-COVID-19 patients – The British Journal of Cardiology

  https://bjcardio.co.uk/2022/01/observational-case-series-of-postural-tachycardia-syndrome-pots-in-post-covid-19-patients/

  There is emerging evidence that a proportion of patients who develop long (post)-COVID-19 have abnormalities in the regulation of their autonomic nervous system manifesting as postural tachycardia syndrome (PoTS). […] The authors recommend an active stand test for patients who present after COVID-19 infection with cardiovascular symptoms including chest pain, palpitations, light-headedness and breathlessness that are worse with the upright posture. […] They further recommend training of clinicians and investment in health services to provide for the anticipated significant increase in patients presenting with PoTS and other forms of autonomic dysfunction due to the COVID-19 pandemic. […] PoTS is mentioned in the NICE guidance as a potential cause of some post-COVID-19 symptoms. […] The American Autonomic Society noted a recent increase in referrals to US autonomic clinics, and anticipate that numbers will increase further as the pandemic progresses.

• #1 Postural Orthostatic Tachycardia Syndrome

  https://practicalneurology.com/articles/2020-mar-apr/postural-orthostatic-tachycardia-syndrome

  Postural orthostatic tachycardia syndrome (POTS) is a clinically defined syndrome with many possible symptoms that relate to dysfunction of the autonomic nervous system. […] The prevalence of POTS is likely unknown, but current epidemiologic studies suggest that up to 1% of the US population may be affected. […] In approximately 12.5% of cases, there is a family history of POTS symptoms, suggesting a genetic contribution to the disorder. […] The diagnosis of POTS, which is clinical and does not require ancillary testing, should be considered in individuals presenting with these symptoms.

• #1 Postural orthostatic tachycardia syndrome (POTS): a diagnostic dilemma – The British Journal of Cardiology

  https://bjcardio.co.uk/2010/02/postural-orthostatic-tachycardia-syndrome-pots-a-diagnostic-dilemma/

  Postural orthostatic tachycardia syndrome (POTS) is a condition that results from orthostatic intolerance. Patients, frequently young females, present with tachycardia, headache, palpitation, sweating, nausea and near syncope, on changing their posture from lying to standing. Tilt-table testing has become the gold standard for diagnosing this disorder. POTS is characterised by orthostatic symptoms and dramatic increase in heart rate on standing, but does not involve orthostatic hypotension. POTS was first described in 1940, and it is considered one of the common conditions in young females. It occurs most commonly between the ages of 12 and 50 years with a male to female ratio of one:five. The underlying pathophysiological mechanism is assumed to be failure of peripheral vascular resistance to increase sufficiently in response to orthostatic stress, and, consequently, venous pooling occurs in the legs resulting in decreased venous return to the heart. POTS is classified as either being primary or secondary. The most common primary form of POTS is called the partial dysautonomic form. These patients seem to suffer from a mild type of autonomic neuropathy; the peripheral vessels cannot constrict when there is orthostatic stress. The secondary form of the disorder is seen in conditions associated with autonomic neuropathy, e.g. diabetes mellitus or amyloidosis, and in conditions that may be associated with intrinsic abnormalities in capacitance vessels, e.g. hypermobility syndromes. The prognosis of POTS depends on the underlying aetiology. About 50% of patients with post-viral POTS will have partial or complete recovery within two to five years. Prognosis is generally better in younger people. Ninety per cent of patients will respond to a combination of physical and pharmacotherapy. In conclusion, POTS is a heterogeneous group of disorders with similar clinical picture. It is underdiagnosed because symptoms mimic vasovagal syndrome and anxiety neurosis. The tilt-table test is the gold standard for diagnosis, and treatment depends on identifying the subtype. Patients with severe disabling symptoms will need a multi-disciplinary approach.

• #1

  https://link.springer.com/article/10.1007/s10286-021-00798-2

  COVID-19 is a global pandemic that has had a devastating effect on the health and economy of much of human civilization. […] Understanding and managing long-COVID POTS will require a significant infusion of health care resources and a significant additional research investment. […] The purpose of this statement from the American Autonomic Society is to provide a statement of need to guide physicians, health systems, researchers and research funding agencies about the impact of Long-COVID POTS. […] Recently, a number of case reports have been published describing patients who developed POTS following a SARS-CoV-2 infection. […] Anecdotal preliminary information from personal communications with autonomic clinics in the USA, UK and Canada suggest an increased incidence of POTS. […] The diagnosis of POTS requires excessive orthostatic tachycardia (heart rate increase of 30 beats per minutes in adults) in the absence of orthostatic hypotension, with associated symptoms of orthostatic intolerance, for at least 3 months.

• #1

  https://link.springer.com/article/10.1007/s10286-021-00798-2

  The number of physicians familiar with the care of POTS is insufficient for the existing (pre-COVID-19) patient volume. […] Anecdotal experience reported in personal communications indicates an increase in the number of patients referred to autonomic specialty clinics, and this is likely to increase as the full impacts of COVID-19 are realized. […] In order to properly care for these patients, more clinical resources will be needed. […] There is much that is not known about Long-COVID POTS. […] Federal funding initiatives designed to support a deeper comprehensive understanding of POTS are needed, in addition to the intentional investment in research to understand Long-COVID POTS. […] Addressing the patient needs of Long-COVID, and especially Long-COVID POTS, will take a significant investment of resources and funding, both for clinical care and research.

• #1 Postural orthostatic tachycardia syndrome | MedLink Neurology

  https://www.medlink.com/articles/postural-orthostatic-tachycardia-syndrome

  Formal epidemiologic studies (eg, case-control studies) are necessary to begin to establish such a causal relationship. […] Although a large cohort study did find a possible association between POTS and COVID-19 vaccination, there was a far stronger link with SARS-CoV-2 infection. […] POTS has significant negative effects on employment, economic status, and quality of life for affected individuals, although existing studies are quite limited and appear biased by strong relationships with patient advocacy groups, even to the point of study design and execution.

• #1 Observational case series of postural tachycardia syndrome (PoTS) in post-COVID-19 patients – The British Journal of Cardiology

  https://bjcardio.co.uk/2022/01/observational-case-series-of-postural-tachycardia-syndrome-pots-in-post-covid-19-patients/

  This series represents a group of patients referred with symptoms and clinical signs of PoTS following recent COVID-19 infection. […] The potential for PoTS as a cause for long-COVID-19 symptoms will require more detailed and organised epidemiological study, and the recognition of this particular condition as a potential cause of symptoms needs to be recognised in long-COVID-19 clinics so that patient symptoms are investigated and managed appropriately. […] The clinical need is already here, and it is likely to increase. We recommend investment by NHS England in secondary and tertiary autonomic services and training of healthcare providers in primary and secondary care (including long-COVID-19 clinics) to recognise and manage patients with PoTS.

• #2 Postural Orthostatic Tachycardia Syndrome

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7046364/

  The term postural orthostatic tachycardia syndrome (POTS) was first used by a team of researchers from Mayo Clinic led by neurologist Philip Low, in 1993. However, the disorder was not new; over the last 160 years, it has been known by many different names, such as neurocirculatory asthenia, orthostatic tachycardia, and orthostatic intolerance. Patients with POTS can be misdiagnosed as having severe anxiety, panic disorder, or chronic fatigue syndrome, because of their similar clinical features. […] The prevalence of POTS is around 0.2% in the general population, and an estimated 500,000 to 1,000,000 individuals in the United States have the disorder. Postural orthostatic tachycardia syndrome can affect individuals of either sex at any age, but 75% to 80% are female, and most patients are between the ages of 15 and 25 years at diagnosis.

• #2 Postural orthostatic tachycardia syndrome | MedLink Neurology

  https://www.medlink.com/articles/postural-orthostatic-tachycardia-syndrome

  Postural orthostatic tachycardia syndrome has a distinct female predominance, with about 80% of cases occurring in females. […] Postural orthostatic tachycardia syndrome primarily affects women of childbearing age, with 80% to 90% of cases being women and most cases occurring between the ages of 15 and 50 years. […] The prevalence ranges between 0.2% and 1.0% in developed countries. […] There is a strong association between POTS and joint hypermobility or Ehlers-Danlos syndrome, although the significance of this has been seriously questioned. […] Postural orthostatic tachycardia syndrome has a distinct female predominance, with about 80% of cases occurring in females. […] The prevalence ranges between 0.2% and 1.0% in developed countries. […] Postural orthostatic tachycardia syndrome primarily affects women of childbearing age, with 80% to 90% of cases being women and most cases occurring between the ages of 15 and 50 years.

• #2 POTS: Causes, Symptoms, Diagnosis & Treatment

  https://my.clevelandclinic.org/health/diseases/16560-postural-orthostatic-tachycardia-syndrome-pots

  Postural orthostatic tachycardia syndrome (POTS) is a condition that causes a number of symptoms when you transition from lying down to standing up, such as a fast heart rate, dizziness and fatigue. […] POTS is common. It affects about 1 to 3 million people in the United States. […] The majority of people with POTS are women aged 15 to 50 years. But men can also have POTS. […] People who have certain autoimmune conditions, such as Sjogrens syndrome, lupus and celiac disease, are also more likely to develop POTS. […] Each case of POTS is different. People with POTS may see symptoms come and go over a period of years. In most cases, with adjustments in diet, medications and physical activity, a person with POTS will experience an improvement in their quality of life. […] The prognosis (outlook) for POTS is generally good, although it can severely disrupt daily living. POTS symptoms may come and go for years. In approximately 80% of cases, the condition improves, but many people have residual symptoms. […] The biggest risk to people with POTS is getting hurt if they faint and fall. […] People with POTS have a normal life expectancy. The condition doesnt decrease life expectancy.

• #2 The POTS (Postural Tachycardia Syndrome) Epidemic: Hydration and Nutrition Issues – Practical Gastro

  https://practicalgastro.com/2019/10/14/the-pots-postural-tachycardia-syndrome-epidemic-hydration-and-nutrition-issues/

  Postural tachycardia syndrome (POTS) is one of the most common causes of orthostatic intolerance and is being increasingly recognized in clinical practice. […] The prevalence of POTS has been estimated at about 170 cases per 100,000 individuals. […] POTS occurs most commonly among adolescent girls and young women and is characterized by typical orthostatic symptoms and is often accompanied by a variety of nonorthostatic symptoms including dry eyes or mouth, headaches, myalgias and a variety of urinary and gastrointestinal (GI) complaints. […] Both orthostatic and nonorthostatic symptoms can be debilitating and contribute substantially to diminished quality of life and overall sense of well being. […] The natural history of POTS does not seem to incur an increased mortality risk. […] Overall, existing data suggest that, while cure is uncommon, many POTS patients improve over time.

• #2 Article: Postural orthostatic tachycardia syndrome (POTS): a common but unfamiliar syndrome (full text) – January 2019 – NJM

  https://www.njmonline.nl/article_ft.php?a=2071&d=1357&i=222

  Postural orthostatic tachycardia syndrome (POTS) is a condition in which a change from a supine to an upright position causes an abnormally large increase in heart rate. A POTS diagnosis is made when patients meet all criteria shown in table 1. POTS is probably underdiagnosed due to the heterogeneity in both presentation and etiology, and therefore the prevalence of POTS is still unsure. Three studies report a prevalence of approximately 170/100,000 in the United States. Mean age of onset of POTS is approximately 30 years and most patients are between the ages of 20-40 years. There is a clear overrepresentation of women with a corresponding female:male ratio of 5:1. […] POTS, first described by Jacob Mendes Da Costa in 1871, is a clinical syndrome and not a distinct disease entity, and has clinical overlap with chronic fatigue syndrome and Ehlers-Danlos syndrome. Clinical diagnostic criteria for POTS are provided in table 1.

• #2 Dysautonomia International: Postural Orthostatic Tachycardia Syndrome

  http://www.dysautonomiainternational.org/page.php?ID=30

  Postural orthostatic tachycardia syndrome (POTS) is a common autonomic nervous system disorder characterized by an excessively fast heart rate and symptoms of lightheadedness upon standing. […] Prior to the COVID-19 pandemic, POTS was estimated to impact 1-3 million Americans, and millions of other people around the world. Experts estimate that the POTS population has doubled since the start of the COVID-19 pandemic.

• #2 Observational case series of postural tachycardia syndrome (PoTS) in post-COVID-19 patients – The British Journal of Cardiology

  https://bjcardio.co.uk/2022/01/observational-case-series-of-postural-tachycardia-syndrome-pots-in-post-covid-19-patients/

  There is emerging evidence that a proportion of patients who develop long (post)-COVID-19 have abnormalities in the regulation of their autonomic nervous system manifesting as postural tachycardia syndrome (PoTS). […] The authors recommend an active stand test for patients who present after COVID-19 infection with cardiovascular symptoms including chest pain, palpitations, light-headedness and breathlessness that are worse with the upright posture. […] They further recommend training of clinicians and investment in health services to provide for the anticipated significant increase in patients presenting with PoTS and other forms of autonomic dysfunction due to the COVID-19 pandemic. […] PoTS is mentioned in the NICE guidance as a potential cause of some post-COVID-19 symptoms. […] The American Autonomic Society noted a recent increase in referrals to US autonomic clinics, and anticipate that numbers will increase further as the pandemic progresses.

• #2 Postural orthostatic tachycardia syndrome – Wikipedia

  https://en.wikipedia.org/wiki/Postural_orthostatic_tachycardia_syndrome

  Postural orthostatic tachycardia syndrome (POTS) is a condition characterized by an abnormally large increase in heart rate upon sitting up or standing. POTS is more common in women than men, with a female-to-male ratio of 4:1. The prevalence of POTS is unknown. One study estimated a minimal rate of 170 POTS cases per 100,000 individuals, but the true prevalence is likely higher due to underdiagnosis. Another study estimated that there are at least 500,000 cases in the United States. Most people with POTS are aged between 20 and 40, with an average onset of 21. Diagnoses of POTS beyond age 40 are rare, perhaps because symptoms improve with age. […] It is estimated that 13 million people in the United States have POTS.

• #2 Postural Orthostatic Tachycardia Syndrome (PoTS) (Remedy BNSSG ICB)

  https://remedy.bnssg.icb.nhs.uk/adults/cardiology/postural-orthostatic-tachycardia-syndrome-pots-under-review/

  Local specialists advise that postural orthostatic tachycardia syndrome (POTS) is a clinical syndrome characterised by an increase in heart rate within 10 minutes of standing (30 beats per minute) in the absence of other causes, such as anaemia, hyperthyroidism, adrenal insufficiency and low body weight. […] Epidemiology: Female sex – prevalence in females predominates over males by 5:1. […] Mean age of onset in adults is about 30 years and most patients are between the ages of 20-40 years. […] POTS is not associated with increased mortality. Fifty percent of patients improve with time alone and two thirds of patients receiving pharmacological therapy report an overall improvement. […] If the diagnosis is not clear or if symptoms are not controlled with management in primary care, then consider referring to a specialist. […] POTS can be difficult to manage and there are currently no licensed medications to treat POTS.

• #2 Postural orthostatic tachycardia syndrome | MedLink Neurology

  https://www.medlink.com/articles/postural-orthostatic-tachycardia-syndrome

  Onset frequently occurs following pregnancy, major surgery or trauma, or presumed viral illness. […] A smaller proportion (10% to 15%) has a family history of orthostatic intolerance. […] There is a strong association between POTS and joint hypermobility or Ehlers-Danlos syndrome. […] In adolescents, over half have joint hypermobility (either Ehlers-Danlos syndrome or hypermobility spectrum disorder), and more than one third have a putative autoimmune or inflammatory trigger including infection, surgery, or trauma. […] However, the purported association of these entities stems from an overlapping pool of vague, subjective symptoms, which is inadequate evidence to conclude that any such relationship exists. […] Anecdotal reports of POTS onset following COVID-19 infection or less commonly following vaccination for COVID-19 infection or improvement in POTS following COVID-19 infection do not by themselves establish a causal association.

• #2 Overview of Postural Orthostatic Tachycardia Syndrome (POTS) for General Cardiologists – ScienceOpen

  https://www.scienceopen.com/hosted-document?doi=10.15212/CVIA.2023.0098

  The natural history of POTS is not well studied. POTS can be precipitated by several immunological stressors, including viral infection, menarche, physical trauma, pregnancy, and surgery. The recent COVID-19 pandemic might have influenced the incidence of POTS, because as many as one-third of highly symptomatic patients with long-COVID meet the diagnostic criteria for POTS. […] In one survey of 94 patients, 24% were disabled and unable to work because of POTS. […] Recent data suggest that POTS is the most common autonomic disorder after COVID-19. In one report, 2%–14% of COVID-19 survivors developed POTS within 6–8 months after infection. The predominant symptoms were tachycardia and palpitations. The proposed pathophysiology is the production of autoantibodies after infection with SARS-CoV-2, the coronavirus causing COVID-19, which in turn activate the sympathetic system and cause autonomic dysregulation and tachycardia. The risk of POTS is also elevated after COVID-19 vaccination, but this risk is lower than the risk of POTS after COVID-19 infection.

• #2 Postural Orthostatic Tachycardia Syndrome

  https://practicalneurology.com/articles/2020-mar-apr/postural-orthostatic-tachycardia-syndrome

  Postural orthostatic tachycardia syndrome (POTS) is a clinically defined syndrome with many possible symptoms that relate to dysfunction of the autonomic nervous system. […] The prevalence of POTS is likely unknown, but current epidemiologic studies suggest that up to 1% of the US population may be affected. […] In approximately 12.5% of cases, there is a family history of POTS symptoms, suggesting a genetic contribution to the disorder. […] The diagnosis of POTS, which is clinical and does not require ancillary testing, should be considered in individuals presenting with these symptoms.

• #2 Forms of Dysautonomia – Dysautonomia Support Network

  https://www.dysautonomiasupport.org/forms-of-dysautonomia/

  Postural Orthostatic Tachycardia Syndrome (POTS) is one of the more common forms of dysautonomia. The key features of POTS are a sustained increased heart rate upon standing and orthostatic intolerance symptoms. However, people with POTS also experience symptoms regardless of position. […] It is estimated that between 500,000 – 3 million Americans have POTS. More than 75% with POTS are female, and the average age of onset is between 15 and 25 years of age. […] Researchers have found that POTS commonly occurs with other conditions such as chronic fatigue syndrome, small fiber neuropathy, mast cell activation disorder, hypermobile Ehlers-Danlos syndrome, migraines, gastrointestinal dysfunction (e.g. irritable bowel syndrome), autoimmune disorders, and fibromyalgia. […] The main POTS subtypes are Hyperadrenergic POTS, Neuropathic POTS, Hypovolemic POTS, and immune-mediated or autoimmune POTS.

• #2 Postural orthostatic tachycardia syndrome – Symptoms, diagnosis and treatment | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/3000308

  Postural orthostatic tachycardia syndrome (POTS) is a clinical syndrome characterised by symptoms of orthostatic intolerance and an increase in heart rate (without orthostatic hypotension) on standing, in the absence of other causes. […] It is also associated with comorbidities such as migraine headaches, irritable bowel syndrome, Ehlers-Danlos syndrome, chronic fatigue syndrome, and autoimmune diseases such as Hashimoto’s thyroiditis and coeliac disease. […] There is a lack of evidence for effective treatments for POTS in children. […] However, it is reasonable to treat children with the same interventions that are recommended for adults, with a focus on promoting salt and fluid intake, physical counterpressure techniques, and reassurance to the patient and their families. […] POTS is a chronic, multi-system disorder that is thought to be due to an autoimmune process.

• #2 Understanding and Managing Postural Orthostatic Tachycardia Syndrome

  https://www.uspharmacist.com/article/understanding-and-managing-postural-orthostatic-tachycardia-syndrome

  Despite the growing number of POTS cases since the start of the COVID-19 pandemic, the epidemiology and pathophysiology of POTS are not fully elucidated. This may result in misdiagnosis of this syndrome related to a paucity of research and the lack of formal education clinicians receive on the diagnosis and management of POTS. Consequently, these patients may also be misinformed.

• #2 Postural Orthostatic Tachycardia Syndrome

  https://practicalneurology.com/diseases-diagnoses/alzheimer-disease-dementias/postural-orthostatic-tachycardia-syndrome/31643/

  POTS is a cause of dizziness, fatigue, cognitive dysfunction, and headaches that can significantly contribute to poor quality of life. […] The prevalence of POTS is likely unknown, but current epidemiologic studies suggest that up to 1% of the US population may be affected. Onset is often between age 15 to 25 years, and more than 75% are in girls and women. […] In approximately 12.5% of cases, there is a family history of POTS symptoms, suggesting a genetic contribution to the disorder. […] The diagnosis of POTS, which is clinical and does not require ancillary testing, should be considered in individuals presenting with these symptoms.

• #3 Dysautonomia International: Postural Orthostatic Tachycardia Syndrome

  https://www.dysautonomiainternational.org/page.php?ID=30

  Postural orthostatic tachycardia syndrome (POTS) is a common autonomic nervous system disorder characterized by an excessively fast heart rate and symptoms of lightheadedness upon standing. […] Prior to the COVID-19 pandemic, POTS was estimated to impact 1-3 million Americans, and millions of other people around the world. Experts estimate that the POTS population has doubled since the start of the COVID-19 pandemic.

• #3 Understanding and Managing Postural Orthostatic Tachycardia Syndrome

  https://www.uspharmacist.com/article/understanding-and-managing-postural-orthostatic-tachycardia-syndrome

  POTS affects anywhere from 1 million to 3 million people in the United States. Reports suggest that women aged 15 to 50 years are more commonly diagnosed with POTS. This condition is characterized by poor blood circulation to the heart when the patient stands up from a supine position. POTS is often misdiagnosed, owing to limited research and training of clinicians about this underappreciated condition. […] It is especially important that clinicians understand the diagnosis and treatment of this syndrome, as it has been triggered by bacterial and viral infections. In fact, researchers have identified a potential association between COVID-19 and POTS. Several case reports have been published in which patients who recovered from COVID-19 continued to experience POTS-like symptoms, including fatigue and lightheadedness. More than 246 million COVID-19 cases have been reported globally, and although few case reports on COVID-associated POTS have been published, the number of people affected by postCOVID-19 POTS is expected to grow as more patients worldwide become infected with severe acute respiratory syndrome coronavirus 2.

• #3 Article: Postural orthostatic tachycardia syndrome (POTS): a common but unfamiliar syndrome (full text) – January 2019 – NJM

  https://www.njmonline.nl/article_ft.php?a=2071&d=1357&i=222

  Postural orthostatic tachycardia syndrome (POTS) is a condition in which a change from a supine to an upright position causes an abnormally large increase in heart rate. A POTS diagnosis is made when patients meet all criteria shown in table 1. POTS is probably underdiagnosed due to the heterogeneity in both presentation and etiology, and therefore the prevalence of POTS is still unsure. Three studies report a prevalence of approximately 170/100,000 in the United States. Mean age of onset of POTS is approximately 30 years and most patients are between the ages of 20-40 years. There is a clear overrepresentation of women with a corresponding female:male ratio of 5:1. […] POTS, first described by Jacob Mendes Da Costa in 1871, is a clinical syndrome and not a distinct disease entity, and has clinical overlap with chronic fatigue syndrome and Ehlers-Danlos syndrome. Clinical diagnostic criteria for POTS are provided in table 1.

• #3 Postural Orthostatic Tachycardia Syndrome (PoTS Syndrome)

  https://patient.info/doctor/postural-tachycardia-syndrome-pots-pro

  PoTS is the most common form of orthostatic intolerance in young people, typically affecting young women. […] The prevalence of PoTS syndrome in the UK is estimated to be 2 in 1,000. It is a diagnosis which is thought to be missed frequently. It is five times as common in women as it is in men. It can occur at any age but is most common between the ages of 15 and 50. […] Prognosis depends on the type and the underlying cause. It is better in younger people. 80% of developmental PoTS symptoms resolve within a few years. Those cases which follow viral infections tend to resolve spontaneously within a few years. 90% respond to some form of treatment. PoTS syndrome may cause significant reduction in quality of life and may lead to anxiety and depression.

• #3 Postural Orthostatic Tachycardia Syndrome (POTS) – Causes, Symptoms, Diagnosis, Treatment and Prognosis

  https://www.medindia.net/health/conditions/postural-orthostatic-tachycardia-syndrome.htm

  Postural Orthostatic Tachycardia Syndrome (POTS) can occur at any age, sex or race. […] It primarily affects females in the age-group 15-50 years. Approximately 80% of females are affected. The remaining 20% include males, including both men and boys. Therefore, the female to male ratio is 5:1. POTS can be precipitated by stressful conditions like sepsis, pregnancy, surgery or trauma. The prevalence of POTS is approximately 170/100,000 population. The mean age of onset in adults is approximately 30 years and ranges between the ages of 20-40 years.

• #3 PoTS: what is postural tachycardia syndrome? – BHF

  https://www.bhf.org.uk/informationsupport/heart-matters-magazine/medical/ask-the-experts/pots

  Postural tachycardia syndrome (PoTS) sometimes called postural orthostatic tachycardia syndrome is a condition that causes a sudden increase in heart rate when sitting or standing up. […] PoTS is caused by a problem in the autonomic nervous system, which controls important body functions, such as your heart rate and breathing, without you having to think about them. […] Its thought that, in some cases, PoTS may be triggered by a bacterial or viral infection such as Covid-19 or glandular fever, pregnancy, surgery or a traumatic event. […] There is evidence that some people with long Covid (when Covid-19 lasts for months after infection) experience similar symptoms to people with PoTS. […] Seven per cent of the people with long Covid in the study met the criteria for a PoTS diagnosis based on clinical guidelines.

• #4 Postural Orthostatic Tachycardia Syndrome

  https://elsevier.health/en-US/preview/postural-orthostatic-tachycardia-syndrome-co

  Postural orthostatic tachycardia syndrome primarily affects females of childbearing age. […] The female:male ratio is more than 5:1. […] The reason for the strong female predominance in postural orthostatic tachycardia syndrome is not known. […] A large online patient-community survey of self-reported postural orthostatic tachycardia syndrome patients found that most initially present with symptoms in adolescence and early adulthood. […] The most common age of symptom onset was 14 years with a median age of 17 years, and 50% of patients had symptom onset before 18 years of age. […] The natural history of postural orthostatic tachycardia syndrome is not clear, but it does not appear to increase the risk of mortality.

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