Diagnosing POTS in children

Postural tachycardia syndrome (often abbreviated to PoTS) is a medical condition in which the heart rate increases abnormally when sitting up, or upon standing. This can lead to patients experiencing dizziness, or sometimes fainting.

PoTs is a condition which can affect almost anyone, although it is more common in girls and women. Symptoms may start from a young age, and can range from mild to severe – they may also come on suddenly, or gradually.The condition is recognised as one which may improve gradually over time, however there are also a number of coping techniques and medications a pediatrician with expertise in this area can provide advice on.


PoTS in children

In many cases the cause of the condition in children is unknown, although it can sometimes be linked to the after-effects of a viral illness or traumatic injury. It is sometimes associated with other conditions, including joint hypermobility syndrome, lupus and diabetes.

What causes PoTS?

As your child sits or stands up, gravity pulls some of their blood into their lower body. Normally, their body responds by constricting (narrowing) the blood vessels, and their heart rate goes up – ensuring their heart and brain are still getting enough blood flow.

However, in children suffering from PoTS, the autonomous nervous system does not work properly. Therefore this automatic reaction doesn’t work properly and causes a noticeable drop in blood supply. This can cause their heart to race abnormally, and make them feel light-headed.

What are the symptoms?

There are many common symptoms such as dizziness, feeling faint or light-headed, shaking and sweating, suffering from headaches, experiencing shortness of breath, chest pains or palpitations.

However, many of these can also be related to other, totally different underlying conditions – so it is important to seek medical advice if you believe your child is suffering from these symptoms.

How is PoTS diagnosed?

Like Hyperadrenergic POTS, this kind of POTS is much rarer, caused by excessive norepinephrine in the body.

Some drugs, such as antidepressants, can worsen this kind of POTS by blocking Norepinephrine Transporter in the body, so it’s important to consult a doctor if the sufferer thinks medication could be worsening symptoms.

Do I need to see a paediatrician with expertise in this area?

If your child is showing symptoms which you think may suggest they are suffering from Postural tachycardia syndrome, it is well worth consulting an age-appropriate medical specialist. There are a number of symptoms seen in children suffering from PoTS that can actually relate to other medical conditions, requiring different treatments. In particular, the condition can be confused with blood pressure issues in girls who are approaching puberty and starting menstruation.


It is also important to seek advice from a medical professional with a specialism in this area. A paediatrician who understands the syndrome is more likely to be able to advice on lifestyle changes, and potential medical interventions, than a non-specialist. It is not uncommon for the symptoms to be misdiagnosed as panic attacks, or anxiety-related problems, again particularly when girls and young women present with certain symptoms so it is well worth your time to seek out an expert to ensure a swift diagnosis and appropriate treatment.

This can be unnerving, particularly for younger children, but a paediatric specialist will be able to reassure and interact with your child in a manner which helps them understand, and better cope with the condition. If you believe your child is showing symptoms of POTS, or has already been diagnosed with the condition, get in touch so that Dr Nair could advice you on appropriate tests and management strategies.

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