Diagnosing Postural Orthostatic Tachycardia Syndrome

What is Postural Orthostatic Tachycardia Syndrome?
Postural Orthostatic Tachycardia Syndrome (POTS) is a type of dysautonomia characterized by a reduced circulation of blood when standing up from a reclining position.

Diagnosing Postural Orthostatic Tachycardia Syndrome
POTS is difficult to diagnose due to the varying symptoms that can occur with this syndrome. Symptoms may occur for long periods of time before a diagnosis is made, as these symptoms can be similar to other disorders. It is important to find a physician with in-depth POTS knowledge in order to obtain a proper diagnosis.

Test for DiagnosingPostural Orthostatic Tachycardia Syndrome
Blood and urine tests are often ordered to rule out other conditions that mimic POTS or to find possible causes of POTS. A quantitative sudomotor axon reflex test (QSART), which measures autonomic nerves that control sweating, may also be performed. This test requires mild electrical stimulation on the skin. An autonomic breathing test can measure the rise and fall of blood rate and pressure during exercise. A skin nerve biopsy which evaluates small nerve fibers can be done. This test is relatively painless and safe. Other general tests can include a tuberculin skin test, echocardiogram, or blood volume with hemodynamic studies.

The tilt table test is the preferred approach in testing for POTS. During this test, the individual will lie down on a table and then be strapped down for stabilization and safety. The test will begin in a horizontal position and slowly move vertically to stimulate an upright position. The physician will closely monitor the heart rate and blood pressure as the table position changes, as POTS causes an increased heart rate and blood pressure when standing. Although fainting can occur, the individual is safely strapped to the tilt table, so there is no change of the individual falling and health care professionals are present the entire time. The tilt table test is a safe and effective way to diagnose POTS.

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