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Digital Healthcare

Understanding postural orthostatic tachycardia syndrome

06 March 2025
Clinical
02 March 2025
Volume 34 · Issue 5
Heart rate monitor

Abstract

Postural orthostatic tachycardia syndrome (PoTS) is a clinically significant condition affecting numerous patients across the UK. This article aims to enhance understanding and management strategies for registered nurses by exploring its pathophysiology, clinical presentations, diagnostic processes and treatment protocols. PoTS, characterised by an excessive increase in heart rate on standing, presents multifaceted symptoms impacting patients’ quality of life. Effective management requires a multidisciplinary approach encompassing pharmacological treatments, lifestyle modifications and psychological support. This review seeks to provide nurses with the knowledge to improve patient outcomes and advocate for holistic care

Postural orthostatic tachycardia syndrome (PoTS) is a complex clinical disorder primarily characterised by a marked increase in heart rate when transitioning from a reclined to an upright position. PoTS falls under the umbrella term of orthostatic intolerance. The term can be deconstructed etymologically:

Predominantly observed in developed nations, PoTS affects between 0.2% and 1.5% of the population, with a pronounced bias towards females, displaying a female-to-male ratio of 5:1, and it is more prevalent in individuals below 40 years of age (Raj, 2013).

Despite its classification as a disorder of the autonomic nervous system, PoTS is multifaceted, with patients experiencing a diverse range of symptoms and triggers. Given its association with the autonomic system, it invariably affects multiple bodily systems. This multifarious presentation, coupled with symptoms that are similar to those of other conditions, often results in a delayed diagnosis. Alarmingly, some patients are mislabelled as having psychiatric disorders such as panic disorders due to overlapping symptoms (Raj, 2013). Boris and Fischer (2024) noted that diagnosing PoTS is complex.

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Postural orthostatic tachycardia syndrome
Autonomic dysfunction
PoTS clinical presentation
Diagnostic procedures
Treatment strategies