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Tilt-table testing, orthostatic vitals and the evaluation of POTS
Postural Orthostatic Tachycardia Syndrome (POTS) is a form of dysautonomia causing rapid heart rate on standing with dizziness, fatigue and brain fog. Diagnosis requires tilt-table or active stand testing.
Kathmandu Neurology Clinic & Cognitive Center
Authored and reviewed by Dr. Jitendra Prasad Yadav (MBBS, MD (Internal Medicine), FICN (Neurology), FCNV, FIHM, NMC 8029). Evidence-based, no fabricated outcomes.
Postural Orthostatic Tachycardia Syndrome (POTS) is a form of dysautonomia causing rapid heart rate on standing with dizziness, fatigue and brain fog. Diagnosis requires tilt-table or active stand testing.
Reviewed by Dr. Jitendra Prasad Yadav, MBBS, MD, FICN, FCNV, FIHM — Consultant Neurologist & Headache Specialist (NMC 8029), Kathmandu Neurology Clinic. For evaluation, book an appointment.
Heart rate increase >30 bpm (or >40 in adolescents) within 10 minutes of standing, without significant blood pressure drop (>20/10 mmHg), with symptoms of cerebral hypoperfusion. Many cases follow viral illness or are associated with Ehlers-Danlos syndrome.
Active stand test or tilt-table test, orthostatic vital signs, heart rate variability, exclusion of hyperadrenergic states, dehydration, anemia and medication effects. Many patients are misdiagnosed with anxiety — objective testing confirms the diagnosis.
Increase fluid (2–3L) and salt (3–5g) intake, compression garments, gradual exercise reconditioning, medications (midodrine, fludrocortisone, low-dose beta-blockers, ivabradine). Avoid triggers: heat, alcohol, large meals, prolonged standing.
Raj SR. Postural tachycardia syndrome (POTS). Circulation 2006Content on this website is for general educational purposes only and does not constitute medical advice, diagnosis, or treatment. It is not a substitute for evaluation by a qualified healthcare professional. Always seek the advice of your physician or other qualified provider with any questions regarding a medical condition. Never disregard professional medical advice or delay seeking it because of something you have read on this website. In case of a medical emergency, contact emergency services immediately. No doctor–patient relationship is established by use of this site or by contacting the clinic through the site.