Condition

POTS (postural orthostatic tachycardia syndrome)

An autonomic disorder causing an abnormal heart-rate rise on standing, managed with graded autonomic rehabilitation and cardiology co-management throughout.

Care area: Neurosciences, Neuromodulation & PainStarts with: Structured assessment

What it is

POTS is an autonomic disorder in which standing triggers an abnormally large increase in heart rate — commonly defined as a sustained rise of 30 beats per minute or more (40+ in adolescents) within ten minutes of standing, without a significant drop in blood pressure — accompanied by symptoms of orthostatic intolerance persisting for six months or more. It can significantly limit daily function, and cardiology co-management is maintained throughout assessment and care.

Common symptoms & concerns

Rapid heart rate on standing accompanied by lightheadedness, palpitations, or chest tightness
Exercise intolerance, extreme fatigue, headache, and mental clouding (“brain fog”)
Tremor, generalized weakness, blurred vision, pallor, and occasionally fainting
Functional severity ranging from mild orthostatic symptoms to substantial disability affecting standing or exercise

Assessment & care

Assessment approach

Assessment confirms diagnostic criteria alongside cardiology co-management before a rehabilitation plan is set, since POTS requires ruling out other causes of the heart-rate change.

In-scope care

In-scope care includes taVNS and structured autonomic rehabilitation via physical therapy, with nutrition/hydration counselling available as a recognised supportive measure. Graded physical reconditioning improves autonomic tolerance over time while taVNS and hydration/nutrition measures address symptom burden during that process.

Care in this area is individualized and outcomes vary. Cardiology co-management is maintained throughout; this pathway does not replace cardiac evaluation.