Postural orthostatic tachycardia syndrome (POTS) is a cerebrovascular autonomic dysfunction that is common in young women. POTS can cause dizziness due to orthostatic intolerance. In patients with orthostatic intolerance, it can be diagnosed when the heart rate increases by more than 30 beats per minute within 10 minutes of standing up through the head-up tilt test. However, even a neuro-otologist has difficulty in diagnosing POTS due to the high possibility of misdiagnosis if not paying attention. In this paper, the clinical symptoms, pathophysiology, diagnosis, and treatment of POTS are investigated. In addition, the latest knowledge of POTS is searched to help diagnose and treat POTS.
Orthostatic dizziness is a common type of dizziness. In general, orthostatic dizziness is provoked by standing or tilting, and subsided by supine position. The patient with orthostatic intolerance complains multiple symptoms such as dizziness, palpitation, lightheadness, fatigue and rarely syncope. Common orthostatic intolerance is orthostatic hypotension (classic, initial, transient, and delayed orthostatic hypotension) and postural orthostatic tachycardia syndrome. Transcranial Doppler is a noninvasive technique that provides real-time measurement of cerebral blood flow velocity. It can be useful for understanding the relationship between orthostatic symptoms and cerebral autoregulatory function. The reciprocal causal relationship between vestibular and autonomic dysfunction should always be kept in mind.
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