Advice for doctors

PoTS is often a missed diagnosis as BP and heart rate are usually measured sitting

It is often misdiagnosed as anxiety, panic attacks, chronic fatigue syndrome etc

There is currently little knowledge of PoTS within the medical community. This is slowly changing as awareness of the condition increases.



1: PoTS should be considered in patients (especially young women) with a combination of unexplained symptoms e.g. dizziness, syncope, fatigue, palpitations/tachycardia, headaches, exercise intolerance, anxiety.

2: Have a high index of suspicion in Chronic Fatigue Syndrome and Joint Hypermobility Syndrome.

3: Perform a Stand Test – pulse rate and BP should be measured 3 times supine (to eliminate an alerting response) then after 2, 5 and 10 minutes of standing quietly.

4: Exclude other pathology with haematological and biochemistry tests and ECG (QTc interval).

5: Request a 24 hour ECG – a normal recording does not exclude PoTS, however.

6: If PoTS is suspected, REFER to a specialist for further investigation and treatment.