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Zhang Q, Chen X, Li J, Du J (December 2014). "Clinical features of hyperadrenergic postural tachycardia syndrome in children". Pediatrics International. 56 (6): 813–816. doi: 10.1111/ped.12392. PMID 24862636. S2CID 20740649. House of Lords collapse 'no big deal' ". BBC News. 25 June 2019. Archived from the original on 9 January 2021 . Retrieved 25 June 2019.

Gunning WT, Stepkowski SM, Kramer PM, Karabin BL, Grubb BP (February 2021). "Inflammatory Biomarkers in Postural Orthostatic Tachycardia Syndrome with Elevated G-Protein-Coupled Receptor Autoantibodies". Journal of Clinical Medicine. 10 (4): 623. doi: 10.3390/jcm10040623. PMC 7914580. PMID 33562074. Jacob G, Costa F, Shannon JR, Robertson RM, Wathen M, Stein M, etal. (October 2000). "The neuropathic postural tachycardia syndrome". The New England Journal of Medicine. 343 (14): 1008–1014. doi: 10.1056/NEJM200010053431404. PMID 11018167. Yang J, Liao Y, Zhang F, Chen L, Junbao DU, Jin H (2014-01-01). "The follow-up study on the treatment of children with postural orthostatic tachycardia syndrome". International Journal of Pediatrics (in Chinese). 41 (1): 76–79. ISSN 1673-4408. Archived from the original on 2022-02-23 . Retrieved 2020-09-27. a b c Fedorowski A (April 2019). "Postural orthostatic tachycardia syndrome: clinical presentation, aetiology and management". Journal of Internal Medicine. 285 (4): 352–366. doi: 10.1111/joim.12852. PMID 30372565. a b Fedorowski A, Li H, Yu X, Koelsch KA, Harris VM, Liles C, etal. (July 2017). "Antiadrenergic autoimmunity in postural tachycardia syndrome". Europace. 19 (7): 1211–1219. doi: 10.1093/europace/euw154. PMC 5834103. PMID 27702852.Ferri FF (2016). Ferri's Clinical Advisor 2017 E-Book: 5 Books in 1. Elsevier Health Sciences. p.1019.e2. ISBN 9780323448383. Archived from the original on 2023-09-06 . Retrieved 2020-08-27. Knight J (2018). "Effects of Bedrest: Introduction and the Cardiovascular System". Nursing Times. 114 (12): 54–57. Archived from the original on 2022-08-10 . Retrieved 2022-08-10– via EMAP. Li H, Zhang G, Zhou L, Nuss Z, Beel M, Hines B, etal. (October 2019). "Adrenergic Autoantibody-Induced Postural Tachycardia Syndrome in Rabbits". Journal of the American Heart Association. 8 (19): e013006. doi: 10.1161/JAHA.119.013006. PMC 6806023. PMID 31547749. Sandroni P, Opfer-Gehrking TL, McPhee BR, Low PA (November 1999). "Postural tachycardia syndrome: clinical features and follow-up study". Mayo Clinic Proceedings. 74 (11): 1106–1110. doi: 10.4065/74.11.1106. PMID 10560597.

Fludrocortisone may be used to enhance sodium retention and blood volume, which may be beneficial not only by augmenting sympathetically mediated vasoconstriction, but also because a large subset of POTS patients appear to have low absolute blood volume. [87] However, fludrocortisone may cause hypokalemia. [88] Lambert E, Lambert GW (2014). "Sympathetic dysfunction in vasovagal syncope and the postural orthostatic tachycardia syndrome". Frontiers in Physiology. 5: 280. doi: 10.3389/fphys.2014.00280. PMC 4112787. PMID 25120493. Testing the cardiovascular response to prolonged head-up tilting, exercise, eating, and heat stress may help determine the best strategy for managing symptoms. [34] POTS has also been divided into several types (see § Causes), which may benefit from distinct treatments. [77] People with neuropathic POTS show a loss of sweating in the feet during sweat tests, as well as impaired norepinephrine release in the leg, [78] but not arm. [1] [77] [79] This is believed to reflect peripheral sympathetic denervation in the lower limbs. [78] [80] [1] People with hyperadrenergic POTS show a marked increase of blood pressure and norepinephrine levels when standing, and are more likely to have from prominent palpitations, anxiety, and tachycardia. [81] [82] [50] [77] a b c d e f g h i j k l m Mar PL, Raj SR (2014). "Neuronal and hormonal perturbations in postural tachycardia syndrome". Frontiers in Physiology. 5: 220. doi: 10.3389/fphys.2014.00220. PMC 4059278. PMID 24982638. a b McDonald C, Frith J, Newton JL (March 2011). "Single centre experience of ivabradine in postural orthostatic tachycardia syndrome". Europace. 13 (3): 427–430. doi: 10.1093/europace/euq390. PMC 3043639. PMID 21062792.Pyridostigmine has been reported to restrain heart rate and improve chronic symptoms in approximately half of people. However, it may cause GI side effects that limit its use in around 20% of its patient population. [91] [21] Garland EM, Celedonio JE, Raj SR (September 2015). "Postural Tachycardia Syndrome: Beyond Orthostatic Intolerance". Current Neurology and Neuroscience Reports. 15 (9): 60. doi: 10.1007/s11910-015-0583-8. PMC 4664448. PMID 26198889. Cheung I, Vadas P (2015). "A New Disease Cluster: Mast Cell Activation Syndrome, Postural Orthostatic Tachycardia Syndrome, and Ehlers-Danlos Syndrome". Journal of Allergy and Clinical Immunology. 135 (2): AB65. doi: 10.1016/j.jaci.2014.12.1146. POTS is more common in females than males. It has also been shown to be linked in patients with acute stressors such as pregnancy, recent surgery, or recent trauma. POTS also has been linked to patients with a history of autoimmune diseases, [51] Long Covid, [55] irritable bowel syndrome, anemia, hyperthyroidism, fibromyalgia, diabetes, amyloidosis, sarcoidosis, systemic lupus erythematosus, and cancer. Genetics likely plays a role, with one study finding that one in eight POTS patients reported a history of orthostatic intolerance in their family. [48] Autoimmunity [ edit ]

Moon J, Kim DY, Lee WJ, Lee HS, Lim JA, Kim TJ, etal. (July 2018). "Efficacy of Propranolol, Bisoprolol, and Pyridostigmine for Postural Tachycardia Syndrome: a Randomized Clinical Trial". Neurotherapeutics. 15 (3): 785–795. doi: 10.1007/s13311-018-0612-9. PMC 6095784. PMID 29500811. The prevalence of POTS is unknown. [34] One study estimated a minimal rate of 170 POTS cases per 100,000 individuals, but the true prevalence is likely higher due to underdiagnosis. [34] Another study estimated that there are at least 500,000 cases in the United States. [6] POTS is more common in women than men, with a female-to-male ratio of 4:1. [77] [119] Most people with POTS are aged between 20 and 40, with an average onset of 21. [2] [77] Diagnoses of POTS beyond age 40 are rare, perhaps because symptoms improve with age. [34] COVID-19 and POTS: What You Should Know". WebMD. Archived from the original on 2021-07-31 . Retrieved 2021-07-31.

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More often with standing: lightheadedness, trouble thinking, tachycardia, weakness, [1] palpitations, heat intolerance, acrocyanosis Graf N (2018). "Clinical Symptoms and Results of Autonomic Function Testing Overlap in Spontaneous Intracranial Hypotension and Postural Orthostatic Tachycardia Syndrome". Cephalalgia Reports. 1: 1–6. doi: 10.1177/2515816318773774. S2CID 79542947. Raj V, Opie M, Arnold AC (December 2018). "Cognitive and psychological issues in postural tachycardia syndrome". Autonomic Neuroscience. 215: 46–55. doi: 10.1016/j.autneu.2018.03.004. PMC 6160364. PMID 29628432. Crnošija L, Krbot Skorić M, Adamec I, Lovrić M, Junaković A, Mišmaš A, etal. (February 2016). "Hemodynamic profile and heart rate variability in hyperadrenergic versus non-hyperadrenergic postural orthostatic tachycardia syndrome". Clinical Neurophysiology. 127 (2): 1639–1644. doi: 10.1016/j.clinph.2015.08.015. PMID 26386646. S2CID 6008891. a b c Bogle JM, Goodman BP, Barrs DM (May 2017). "Postural orthostatic tachycardia syndrome for the otolaryngologist". The Laryngoscope. 127 (5): 1195–1198. doi: 10.1002/lary.26269. PMID 27578452. S2CID 24233032.

Vernino S, Bourne KM, Stiles LE, Grubb BP, Fedorowski A, Stewart JM, etal. (November 2021). "Postural orthostatic tachycardia syndrome (POTS): State of the science and clinical care from a 2019 National Institutes of Health Expert Consensus Meeting - Part 1". Autonomic Neuroscience. 235: 102828. doi: 10.1016/j.autneu.2021.102828. PMC 8455420. PMID 34144933. Clinical trial number NCT00409435 for "A Study of Pyridostigmine in Postural Tachycardia Syndrome" at ClinicalTrials.gov There may be a loss of neurovascular coupling and reduced functional hyperemia in response to cognitive challenge under orthostatic stress – perhaps related to a loss of autoregulatory buffering of beat-by-beat fluctuations in arterial blood flow. [47] Causes [ edit ] Boris JR, Bernadzikowski T (December 2018). "Utilisation of medications to reduce symptoms in children with postural orthostatic tachycardia syndrome". Cardiology in the Young. 28 (12): 1386–1392. doi: 10.1017/S1047951118001373. PMID 30079848. S2CID 51922967.a b Tahir F, Bin Arif T, Majid Z, Ahmed J, Khalid M (April 2020). "Ivabradine in Postural Orthostatic Tachycardia Syndrome: A Review of the Literature". Cureus. 12 (4): e7868. doi: 10.7759/cureus.7868. PMC 7255540. PMID 32489723.