Understanding POTS
Postural Orthostatic Tachycardia Syndrome (POTS) is characterized by an increase in heart rate of at least 30 beats per minute (or to >120 bpm) within 10 minutes of standing, without a significant drop in blood pressure.
Common Symptoms
- Dizziness or lightheadedness
- Fainting or near-fainting
- Heart palpitations
- Brain fog
- Fatigue
- Nausea
Prevalence in PAIS
POTS and other forms of orthostatic intolerance are estimated to affect up to 40% of ME/CFS patients and many Long COVID sufferers.
The NASA Lean Test
Originally developed to assess orthostatic tolerance in astronauts, this simple test can be performed in any clinical setting with minimal equipment.
Procedure
- Patient rests supine for 5-10 minutes
- Record baseline heart rate and blood pressure
- Patient stands and leans against a wall (reduces muscle pump)
- Record vitals at 1, 5, and 10 minutes
- Watch for HR increase ≥30 bpm or symptom reproduction
Safety Note: Have a chair or bed nearby. Some patients may feel faint. The test should be stopped if severe symptoms occur.