Fast Five Quiz: Postural Orthostatic Tachycardia Syndrome (POTS)

Yasmine S. Ali, MD


March 15, 2022

Nonpharmacologic therapy is the first-line treatment for POTS. This includes withdrawing medications that may worsen the condition, patient education (eg, avoiding triggers), reducing venous pooling with compression garments, and dietary changes. The addition of salt to the diet (slowly up to 10 g) and increased fluids (2-3 L) is recommended in patients with POTS. In addition, patients should begin a graduated, supervised exercise program. This should initially be restricted to nonupright exercises (eg, rowing machines, recumbent cycles, swimming).

If nonpharmacologic treatments are not wholly effective, medications may be used to address specific concerns. No drugs are approved by the US Food and Drug Administration specifically for POTS. Common medications used for various aspects of the condition include fludrocortisone, which increases salt retention and plasma volume. Beta-blockers may be used to reduce upright tachycardia. Clonidine and alpha-methyldopa can be beneficial in the hyperadrenergic subtype of POTS with hypertension as a predominant symptom. Ivabradine has also been used to lower heart rate and provide symptomatic relief in patients with POTS when other medications have failed.

Learn more about the treatment of POTS and related conditions.

This Fast Five Quiz was excerpted and adapted from the Medscape article Idiopathic Orthostatic Hypotension and other Autonomic Failure Syndromes.

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