POTS is a disorder of the autonomic nervous system that can affect how the body regulates heart rate and blood flow when a person changes position — such as standing up from sitting or lying down.
Postural Orthostatic Tachycardia Syndrome (POTS) is a form of dysautonomia — a dysfunction of the autonomic nervous system, which controls involuntary body functions such as heart rate, blood pressure, and circulation.
In POTS, when a person stands up, the heart rate increases by an abnormally large amount and other symptoms of poor blood circulation can occur. These symptoms improve or resolve when the person lies back down. POTS is classified as a syndrome, not a single disease, meaning it has multiple possible underlying causes.
According to research published in peer-reviewed medical journals, POTS affects an estimated 1–3 million people in the United States, with at least one-third developing symptoms before age 18. It is more commonly recognized in adolescent girls and young women, though it can affect anyone.
Children with POTS are just anxious or looking for attention.
POTS is a recognized medical syndrome with measurable physiological abnormalities, including documented changes in heart rate response. Research published in peer-reviewed journals, including from the American Academy of Pediatrics, confirms its physical nature.
If a child looks healthy, they must be fine.
POTS symptoms are largely invisible. A child may appear healthy on the outside while experiencing significant dizziness, fatigue, and difficulty functioning. This invisibility can contribute to misunderstanding from peers, teachers, and even some healthcare providers.
POTS will go away quickly with rest.
POTS can be a chronic condition requiring medical management. Research suggests that with appropriate treatment, many adolescents see improvement over time, but recovery is often gradual and varies between individuals.
Diagnosis of POTS typically involves a thorough medical history, physical examination, and specific testing. In children and adolescents, a common diagnostic criterion is a heart rate increase of at least 40 beats per minute upon standing (compared to 30 bpm in adults), along with symptoms of orthostatic intolerance.
A tilt table test, in which the patient is moved from lying to standing position while monitored, may be used. Other tests rule out conditions that can cause similar symptoms.
Treatment is individualized and may include:
A cardiologist, neurologist, or autonomic specialist familiar with POTS typically leads care. Management is often multidisciplinary.
The following organizations provide additional information. Heart & Hope Project is not affiliated with these organizations.
Dysautonomia International https://www.dysautonomiainternational.org/page.php?ID=30 American Academy of Pediatrics — Pediatric POTS Overview https://publications.aap.org/pediatrics/article/150/1/e2021054945/188336/ National Institutes of Health (NIH) — POTS Information https://www.ninds.nih.gov/health-information/disorders/postural-tachycardia-syndrome