Cutsforth-Gregory, Jeremy K, Sandroni, Paola · Handbook of clinical neurology · 2019 · DOI
Postural tachycardia syndrome (POTS) is a condition where your heart rate jumps dramatically when you stand up, causing dizziness, lightheadedness, or other symptoms of not enough blood reaching your brain. It happens five times more often in women than men and can have several different causes, including problems with nerve signals, low blood volume, or deconditioning. Treatment focuses on helping patients stand longer and stay active, using approaches like drinking more fluids, wearing compression socks, and sometimes taking medications.
Many ME/CFS patients experience POTS or POTS-like symptoms as part of their condition, making understanding its mechanisms and treatment options directly relevant. This comprehensive clinical review provides clinicians and patients with an evidence-based framework for recognizing different subtypes of POTS and tailoring management accordingly. Understanding the multiple pathophysiologic pathways in POTS may help clarify the heterogeneity observed in ME/CFS populations.
This review does not provide new primary data demonstrating causal mechanisms or comparative efficacy of different treatments. It does not establish the prevalence of POTS specifically within ME/CFS populations or prove that managing POTS improves ME/CFS outcomes. The comorbidity descriptions are associative rather than causal—finding that conditions co-occur does not establish a mechanism linking them.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
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