Lau et al. (2026)
- Authors: Dennis H. Lau, Artur Fedorowski, Satish R. Raj, Caelum Schild, Laura A. Pace, Svetlana Blitshteyn, Vidya Raj, Jeffrey R. Boris, Lesley Kavi, Marie-Claire Seeley, Celine Gallagher
- Institutes: Australian Dysautonomia and Arrhythmia Research Collaborative, The University of Adelaide, Adelaide, Australia, Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden, Libin Cardiovascular Institute, Cumming School of Medicine, University of Calgary, Calgary, Canada
- Publisher: Heart, Lung and Circulation
- Link: DOI
Summary
This comprehensive review consolidates the current medical understanding of POTS, emphasizing its role as a complex, multi-system autonomic disorder rather than just a cardiac issue. It highlights the urgent need for specialized multidisciplinary care teams to address the significant diagnostic delays and the broad symptom burden that severely impacts patient quality of life.
What was researched?
The researchers conducted a state-of-the-art review to synthesize current knowledge on the diagnosis, pathophysiology, and management of Postural Orthostatic Tachycardia Syndrome (POTS).
Why was it researched?
POTS is frequently misunderstood or missed by healthcare professionals, leading to significant diagnostic delays for a condition that causes profound functional impairment and often follows viral infections like COVID-19.
How was it researched?
The authors performed a narrative review of existing clinical literature and expert consensus to outline the best practices for diagnosis using orthostatic challenge tests and contemporary treatment strategies.
What has been found?
The review identifies POTS as a highly heterogeneous condition with multifaceted origins, including autoimmune, hyperadrenergic, and neuropathic components. Effective management requires a combination of non-pharmacologic lifestyle changes and pharmacologic interventions such as ivabradine 💊, though many current treatments offer only modest relief.
Discussion
A major challenge identified is the severe shortage of medical specialists trained in autonomic medicine, which limits patient access to necessary long-term follow-up and monitoring. The complexity of the syndrome necessitates a primary care team supported by specialist nurses and allied health professionals.
Conclusion & Future Work
The authors conclude that a multidisciplinary approach is essential for managing POTS effectively. They call for increased research funding and a larger workforce of specialized investigators to better understand the disease’s etiology and develop more effective therapies.