Postural orthostatic tachycardia syndrome (POTS) is a dysautonomia that has only been recognized for the past 30 years. Common symptoms include dizziness, headaches, fatigue, brain fog, and insomnia, but many other symptoms have been reported. The symptoms are often quite debilitating.
Because the symptoms can be quite varied, and because many clinicians may still be unfamiliar with POTS, patients can be symptomatic for months and years before a diagnosis is made. Additionally, because there is still much that is unclear about the etiology and pathophysiology, many patients, families, and clinicians experience frustration with the treatment options for POTS.
This week, Pediatrics is early releasing a State of the Art review article, entitled “Pediatric Postural Orthostatic Tachycardia Syndrome: Where We Stand,” by Dr. Jeffrey Boris and Dr. Jeffrey Moak, both pediatric cardiologists with extensive experience working with patients with POTS (10.1542/peds.2021-054945).
This article is a must-read for all clinicians who care for children and adolescents. There is much here – diagnostic criteria, risk factors, neurohormonal and hemodynamic abnormalities, clinical assessment, and clinical management. If you don’t have time to read the entire article right now, each section starts with “take-home points.” (But put the article on your bedside table – or wherever you put articles that you plan to read soon – for when you have a few minutes to digest the entire article.)
I think this is also an article that can be shared with patients and their families. A fair number of these patients will have experienced feelings of “Is this all in my head?”, and they will draw comfort and reassurance from this article that clearly refutes that notion.