POTS Diagnostic Criteria

“All of the following criteria must be met:

  • Sustained heart rate increase of ≥ 30 beats/min (or ≥ 40 beats/min if patient is aged 12–19 yr) within 10 minutes of upright posture.

  • Absence of significant orthostatic hypotension (magnitude of blood pressure drop ≥ 20/10 mm Hg).

  • Very frequent symptoms of orthostatic intolerance that are worse while upright, with rapid improvement upon return to a supine position. Symptoms vary between individuals, but often include lightheadedness, palpitations, tremulousness, generalized weakness, blurred vision, and fatigue.

  • Symptom duration ≥ 3 months,” (Raj et al., 2022).

  • “Absence of other conditions that could explain sinus tachycardia such as:

    • Acute hypovolemia (from dehydration or blood loss)

    • Anemia

    • Orthostatic hypotension

    • Endocrinopathy

      • Adrenal insufficiency

      • Carcinoid tumour

      • Hyperthyroidism

      • Pheochromocytoma

    • Adverse effects from medication

    • Panic attacks and severe anxiety

    • Prolonged or sustained bed rest

    • Recreational drug effects,” (Raj et al., 2020).

Sources:

Raj, S. R., Fedorowski, A., & Sheldon, R. S. (2022). Diagnosis and management of postural orthostatic tachycardia syndrome. Canadian Medical Association Journal, 194(10). https://doi.org/10.1503/cmaj.211373

Raj, S. R., Guzman, J. C., Harvey, P., Richer, L., Schondorf, R., Seifer, C., Thibodeau-Jarry, N., & Sheldon, R. S. (2020). Canadian Cardiovascular Society Position Statement on postural orthostatic tachycardia syndrome (POTS) and related disorders of chronic orthostatic intolerance. Canadian Journal of Cardiology, 36(3), 357–372. https://doi.org/10.1016/j.cjca.2019.12.024