Postural Tachycardia Syndrome (POTS)

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What is postural orthostatic tachycardia syndrome (POTS)?

Postural orthostatic tachycardia syndrome (POTS) is one of a group of disorders that have orthostatic intolerance (OI) as their primary symptom. OI is a condition in which an excessively reduced volume of blood returns to the heart after an individual stands up from a lying down position. The primary symptom of OI is lightheadedness or fainting.

In POTS, the lightheadedness or fainting is also accompanied by a rapid increase in heartbeat of more than 30 beats per minute, or a heart rate that exceeds 120 beats per minute, within 10 minutes of rising. The faintness or lightheadedness of POTS is relieved by lying down again.

Anyone at any age can develop POTS, but it mainly affects women between the ages of 15 to 50 years of age. Some women report an increase in episodes of POTS right before their menstrual periods. POTS often begins after a pregnancy, major surgery, trauma, or a viral illness. It may make individuals unable to exercise because the activity brings on fainting spells or dizziness.

Some people with Ehler-Danlos syndrome type III (also called hypermobile Ehlers–Danlos syndrome, or hEDS), an inherited connective tissue disorder that is caused by defects in a protein called collagen, may also be diagnosed with POTS.

The cause of the disorder is unknown. Treatment is targeted at relieving low blood volume or regulating circulatory problems that may cause the disorder. A number of drugs seem to be effective in the short term. Whether they help in long term is uncertain.

Simple interventions such as adding extra salt to the diet and attention to adequate fluid intake are often effective.

The drugs fludrocortisone (for those on a high salt diet) and midodrine in low doses are often used to increase blood volume and narrow blood vessels. Drinking 16 ounces of water (two glasses) before getting up can also help raise blood pressure. Some individuals are helped by beta receptor blocking agents. There is some evidence that an exercise program can gradually improve orthostatic tolerance.

POTS may follow a relapsing-remitting course, in which symptoms come and go, for years. In most cases, an individual with POTS improves to some degree and becomes functional, although some residual symptoms are common.

Learn About Clinical Trials
Clinical trials are studies that allow us to learn more about disorders and improve care. They can help connect patients with new and upcoming treatment options.

How can I or my loved one help improve care for people with postural tachycardia syndrome (POTS)?

Consider participating in a clinical trial so clinicians and scientists can learn more about POTS and related disorders. Clinical research uses human volunteers to help researchers learn more about a disorder and perhaps find better ways to safely detect, treat, or prevent disease.

All types of volunteers are needed—those who are healthy or may have an illness or disease—of all different ages, sexes, races, and ethnicities to ensure that study results apply to as many people as possible, and that treatments will be safe and effective for everyone who will use them.

For information about participating in clinical research visit NIH Clinical Research Trials and You. Learn about clinical trials currently looking for people with POTS at

Where can I find more information about postural tachycardia syndrome (POTS)?

Information may be available from the following resources:

Dysautonomia International

Dysautonomia Youth Network of America, Inc.
Phone: 301-705-6995

National Dysautonomia Research Foundation
Phone: 651-327-0367 

Order publications from the NINDS Catalog
The NINDS Publication Catalog offers printed materials on neurological disorders for patients, health professionals, and the general public. All materials are free of charge, and a downloadable PDF version is also available for most publications.