If you mention POTS (Postural Orthostatic Tachycardia Syndrome) in everyday conversation, you’ll find that a good number of people have never heard of it, including some people who work in the healthcare industry.
It’s not as if POTS is an extremely rare disease; in fact it’s likely that tens of thousands of Australians live with the disease, with the number rising after the COVID-19 pandemic.
Unfortunately POTS is, at this point in time, still not very well understood, and a lot of questions surrounding its causes and treatments still remain.
In this article, we’d like to shed light on some of the things we do know about POTS.
Disclaimer: This article is for general information purposes only and is not meant for use in diagnosis. If you are experiencing symptoms such as those mentioned here, seek the help of a qualified medical professional.
…that the person’s heart rate speeds up (to abnormal levels) when the person stands up.
To break down the term:
In a healthy person, when you stand up, blood briefly pools in your lower body, but the autonomic nervous system quickly compensates by increasing the heart rate slightly and constricting blood vessels. In persons with POTS, this heart rate increase happens excessively.
Because our blood flow affects so much of our bodily functions, this abnormal increase in heart rate can cause various symptoms.
The last word, syndrome, refers to a group of concurrent signs and symptoms that characterise a particular disease.
Although the fast heartbeat is the defining symptom that gives POTS its name, the disorder actually involves a cluster of symptoms. These include:
The vast majority of people with POTS report experiencing fatigue.
These symptoms can manifest in a wide range of severity from person to person. In more severe cases, POTS can be debilitating, preventing an individual from working and pursuing other endeavours.
Because its symptoms overlap with conditions like anxiety, chronic fatigue syndrome, and even heart disease, POTS is frequently misdiagnosed or dismissed. It often takes years for patients to receive a correct diagnosis.
Currently, the diagnostic criteria for POTS is a heart rate increase of 30 beats per minute (bpm) or more, or over 120 bpm, within the first 10 minutes of standing. (Source: Dysautonomia International)
Diagnostic criteria require that symptoms have persisted for at least 6 months, and that no other medical condition better explains them.
POTS is a dysautonomia, which refers to a malfunction in the autonomic nervous system, which regulates involuntary bodily functions such as heart rate. This is a combination of the Greek prefix dys- meaning bad, and autonomia meaning self-governing.
However, what exactly causes this malfunction is not yet known. Possible causes and risk factors that are being considered are autoimmune conditions and genetic predisposition. Many patients also report that their symptoms began following a viral illness.
In fact…
A 2025 study published in the European Heart Journal – Quality of Care and Clinical Outcomes reported that between 2018 and 2024, the incident rates for POTS rose from 1.42 to 20.3 cases per 1,000,000 person-year. This suggests a potential link between COVID-19 infection and the development of post-viral POTS
POTS is not uncommonly misdiagnosed—or perhaps dismissed—as anxiety, possibly because several symptoms overlap.
But to be clear: POTS is a physiological condition rooted in a dysfunction of the autonomic nervous system. It is not rooted in psychological causes.
To date, there is no known cure for POTS. However, there are ways to manage it and make living with it easier.
Management typically includes:
As the symptoms and severity of POTS can vary greatly between patients, the key is a personalised, multidisciplinary approach, often involving cardiology, neurology, and physical therapy working together to tailor the treatment approach to the individual’s condition and needs.
Our team is here to help. We work carefully with patients and other healthcare professionals such as cardiologists and neurologists to create a therapy plan that is tailored to the individual, and employ science-based modalities to safely improve and maintain their physical and cardiovascular fitness.
Call 02 8808 4000 or message us through this form to enquire.