Postural orthostatic tachycardia syndrome: insights into pathogenesis and treatment

Postural orthostatic tachycardia syndrome (POTS) is a form of chronic dysautonomia, most commonly seen in women of child-bearing age and often associated with reduced quality of life. Current diagnostic criteria require an increase in heart rate of 30 beats per minute (bpm), or over 120 bpm in the first 10 min of standing, in the absence of orthostatic hypotension, and associated with orthostatic intolerance. Other symptoms suggestive of autoimmune failure include sudomotor dysfunction and gastrointestinal dysmotility. However, the heterogeneity of clinical presentation and uncertainty of pathogenesis, often prompts a search for alternative causes before a diagnosis of POTS, a made