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Postural Orthostatic Tachycardia Syndrome (POTS)

Postural Orthostatic Tachycardia Syndrome (POTS)

Does your heart beat faster when you stand up? Do you feel dizzy, shaky? Like you’re going to faint or even throw up? Maybe you’re really tired or have brain fog.

You might have a condition called postural orthostatic tachycardia syndrome — POTS for short. POTS is a chronic (lifelong) illness that’s often hard to diagnose because there are lots of different symptoms, and they can come and go for many years. It can happen when a virus, injury or pregnancy affects nerve cells controlling blood flow to your heart. Any change in your posture can trigger symptoms like fainting, vomiting and forgetfulness. And although it’s not life-threatening, POTS can be frustrating to live with.

That’s where we come in. Cleveland Clinic neurologists can help diagnose and manage your POTS symptoms with the newest therapies and treatments. If you’re living with POTS, we can help make your daily life better and brighter.

Why choose Cleveland Clinic for Postural Orthostatic Tachycardia Syndrome Care?

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High volume specialty:

Our trusted neurologists treat many people with POTS symptoms each year. Our experience means you get outstanding care. We often diagnose patients on their first visit. Meet our team.

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Caring approach:

Our team gives you the attention you deserve, even when your condition is hard to describe. We understand what you’re going through and know what it takes to get to the bottom of what’s happening.

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Patient-centered care:

After diagnosis, you can choose to meet with other people who have POTS for in-depth discussions about POTS and recovery. These small, private group sessions (called shared medical appointments) are led by members of our team. They’re typically longer than regular appointments so you have more time to learn and share. Everything you share during these appointments is confidential.

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Virtual visits:

People nationwide choose us for POTS care. If you don’t live near one of our locations, you might be able to see your provider from the comfort of home with a virtual visit. All you need is a smartphone, tablet, computer and an internet connection.

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National recognition:

U.S. News & World Report consistently ranks Cleveland Clinic a top hospital in the nation. Newsweek has also named us a top hospital in the world.

POTS Diagnosis at Cleveland Clinic

We’ll begin by listening carefully as you describe your POTS symptoms and how they affect your daily life. This information helps us decide if you need more tests, such as:

  • Tilt table test: This is the gold standard for diagnosing POTS. You’ll lie down on a special table with soft Velcro straps across your chest and legs so you don’t fall. The table slowly tilts upward as if you were standing up. Then, we’ll measure your blood pressure and heart rate as your body changes position.
  • Autonomic breathing test: This test shows how your heart rate and blood pressure respond to exercise.
  • Quantitative sudomotor axon reflex test (QSART): This test measures the nerves that control sweating.
  • Neurological exam: This exam checks to see how your brain and nervous system are working.
  • Skin nerve biopsy: This test checks for conditions like small fiber sensory neuropathy that can lead to POTS.


POTS Treatment at Cleveland Clinic

Postural orthostatic tachycardia syndrome treatment involves therapies, education and self-care practices, like exercising. We tailor treatment recommendations to your needs. Recovery takes time. It’s not uncommon for it to take six months to a year to feel better. Your treatment may include:

  • Biofeedback, which uses painless sensors to measure your body’s autonomic response to treatment in real time. For example, easing muscle tension can lower your heart rate.
  • Cardiac rehabilitation, which is a medically supervised exercise program that provides a safe environment for learning to exercise.  
  • Medications, which may control your heart rate, improve blood flow or raise blood pressure. You may also need headache medicine if your POTS symptoms include migraines.
  • Talk therapy, which involves meeting with our health psychologist. These conversations help you cope with the challenges of living with POTS.
  • Thigh-high medical compression stockings, which help push blood from your legs up toward your heart.

Shared medical appointments for POTS

Shared medical appointments let you connect with other people with POTS for extra support and to learn more about POTS and recovery. Our POTS experts lead each small, private group session. These group appointments focus on topics like how to get relief from POTS, exercise recommendations and how to get the most out of treatment.

Everything shared in these appointments is strictly confidential. Individualized care in a private virtual setting is also available if you need it.

Taking the Next Step

Even though POTS isn’t a life-threatening condition, it can interrupt your daily life. But there’s good news — there are treatment options available that can help. If you’ve been living with POTS, we can help. We’ll take the time to get to know you and learn about the symptoms you’ve experienced. Working together, we’ll craft a treatment plan that helps you get back to doing the things you want to do — without POTS getting in the way.

Getting an appointment with Cleveland Clinic postural orthostatic tachycardia experts is easy. We can help you get the care you need.


Getting an appointment with Cleveland Clinic postural orthostatic tachycardia experts is easy. We can help you get the care you need.

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