What Is Postural Orthostatic Tachycardia Syndrome (POTS)?

Postural Orthostatic Tachycardia Syndrome (POTS) is a condition affecting the autonomic nervous system, which regulates heart rate and blood pressure during changes in body position.

Normally, when a person moves from lying down to standing, blood vessels tighten, and heart rate increases slightly to maintain blood flow to the brain. In individuals with POTS, this response does not function properly, leading to an excessive increase in heart rate when standing.

POTS is classified as a form of orthostatic intolerance, meaning the body has difficulty tolerating prolonged upright posture. An increase in heart rate of 30 beats per minute or more within 10 minutes of standing without a significant drop in blood pressure is typically used as part of the diagnostic criteria.

What are the symptoms of POTS?

Symptoms vary in severity and presentation. Many people with POTS experience:

• Rapid heart rate upon standing

• Heart palpitations

• Dizziness or lightheadedness

• Near fainting or fainting

• Brain fog and difficulty concentrating

• Exercise intolerance

• Persistent fatigue

• Chest discomfort

• Headaches

• Nausea

• Poor sleep

• Anxiety-like symptoms

Symptoms may worsen with prolonged standing, heat exposure, dehydration, or after illness. Although POTS is not life-threatening and does not increase the risk of heart attack or stroke, symptoms can significantly impact daily activities and quality of life.

Who diagnoses POTS?

Evaluation for suspected POTS is typically performed by cardiologists, electrophysiologists, or physicians with experience in autonomic disorders.

Diagnosis generally requires:

• Detailed medical history

• Physical examination

• Heart rate and blood pressure measurements while lying and standing

• Testing to rule out structural heart disease or rhythm abnormalities

Additional testing may include:

• Electrocardiogram (ECG)

• Echocardiogram

• Orthostatic vital sign testing

• Stress testing

• Laboratory evaluation

In some cases, specialized autonomic testing such as tilt table testing may be performed at dedicated autonomic laboratories.

Important information about POTS care at Vivify Medical

Many patients seeking care for POTS have already undergone extensive diagnostic testing before arriving at our practice.

Because management of established POTS can be complex, highly time-intensive, and often requires multidisciplinary long-term care, ongoing treatment is frequently coordinated through specialized autonomic or academic centers.

Vivify Medical primarily provides cardiovascular evaluation for patients who have not yet been diagnosed and want to better understand symptoms such as dizziness, palpitations, or rapid heart rate upon standing.

If POTS or another condition is suspected, appropriate diagnostic evaluation and referrals may be recommended.

When should you seek evaluation?

You may benefit from cardiovascular evaluation if you:

• Have not been diagnosed with POTS

• Experience unexplained dizziness or rapid heart rate when standing

• Have fainting or near-fainting episodes

• Want to rule out underlying heart conditions

A cardiac evaluation helps determine whether symptoms are related to POTS or another cardiovascular cause.

POTS Evaluation in NYC – Financial District

Vivify Medical, located in the Financial District of Lower Manhattan, provides cardiovascular assessment for patients experiencing symptoms that may resemble orthostatic intolerance or autonomic dysfunction.

If you have not yet received a diagnosis and are looking to better understand your symptoms, our team can perform an initial cardiac evaluation and guide next steps when appropriate.