Postural Orthostatic Tachycardia Syndrome (Pots): Clinical Presentation, Diagnosis, Pathophysiology and Treatment Options – A Literature Review

Introduction: Postural orthostatic tachycardia syndrome (POTS) is a chronic disorder of the autonomic nervous system characterised by orthostatic intolerance and an excessive increase in heart rate (≥30 beats per minute) upon standing, in the absence of orthostatic hypotension. Patients often experience additional symptoms such as fatigue, dizziness and palpitations. The disorder predominantly affects young women. Although the aetiology remains unclear, several mechanisms have been proposed. Due to its complex clinical presentation and limited awareness among healthcare professionals, POTS is frequently misdiagnosed. Aim: The aim of this review is to summarise the current knowledge regarding the aetiology, clinical presentation, diagnosis and treatment of postural orthostatic tachycardia syndrome. Materials and methods: This review is based on literature available in the PubMed database. Articles were identified using keywords including postural orthostatic tachycardia syndrome, POTS, orthostatic intolerance and tachycardia, and the most relevant publications were analysed. Results: POTS remains a moderately understood disorder. The prevalence is estimated at approximately 0.2% of the general population, with women of reproductive age accounting for up to 90% of cases. The pathophysiology is multifactorial and includes three main mechanisms: partial autonomic neuropathy, hypovolemia and a hyperadrenergic state. Management includes both non-pharmacological interventions, such as increased fluid intake and lifestyle modification, and pharmacological therapies including beta-blockers and ivabradine. Conclusions: POTS remains a diagnostic and therapeutic challenge. Increased awareness and further research are essential to improve diagnosis and patient outcomes.