How is POTS Diagnosed?

POTS stands for Postural Orthostatic Tachycardia Syndrome.

The diagnoses evades many patients for several years, but it is relatively simple.

This diagnostic criteria comes straight from Dysautonomia International:

Diagnostic Criteria
The current diagnostic criteria for POTS is a heart rate increase of 30 beats per minute (bpm) or more, or over 120 bpm, within the first 10 minutes of standing, in the absence of orthostatic hypotension.^1,2,3,4 In children and adolescents, a revised standard of a 40 bpm or more increase has recently been adopted.^4,5 POTS is often diagnosed by a Tilt Table Test, but if such testing is not available, POTS can be diagnosed with bedside measurements of heart rate and blood pressure taken in the supine (laying down) and standing up position at 2, 5 and 10 minute intervals. Doctors may perform more detailed tests to evaluate the autonomic nervous system in POTS patients, such as Quantitative Sudomotor Axon Reflex Test (QSART, sometimes called Q-Sweat), Thermoregulatory Sweat Test (TST), skin biopsies looking at the small fiber nerves, gastric motility studies and more.

Can I Diagnose Myself With POTS?

You can certainly perform the “poor man’s tilt table test” described above, to see if your heart rate increases 30 BPM or more, and take this information with you to your doctor.

Lay down for 5 minutes. Take your HR. Stand up, immediately take your HR. Stay standing and take your HR at 2, 5, and 10 minute intervals. Do not move around or talk during this process.

Sources
1. Postural Tachycardia Syndrome. Blair P. Grubb, Circulation. 2008; 117: 2814-2817.

2. National Institute of Health, Neurological Institute of Neurological Disorders and Stroke, Postural Tachycardia Syndrome Information Page.

3. The Postural Tachycardia Syndrome (POTS): Pathophysiology, Diagnosis & Management. Satish R Raj, MD MSCI, Indian Pacing Electrophysiol J. 2006 April-Jun; 6(2): 84-99.

4. Consensus statement on the definition of orthostatic hypotension, neurally mediated syncope and the postural tachycardia syndrome. Autonomic Neuroscience: Basic and Clinical 161 (2011) 46-48.

5. Postural tachycardia in children and adolescents: what is abnormal? Singer W, Sletten DM, Opfer-Gehrking TL, Brands CK, Fischer PR, Low PA, J Pediatr. 2012 Feb;160(2):222-6. Epub 2011 Oct 11.