The modern age of clinical guidelines began with a 1992 institute of medicine report which defined guidelines as systematically developed statements meant to assist practitioner and patient decisions about healthcare for specific clinical circumstances. The key words there were ‘assist practitioner AND patient decisions’. However over the course of the last 30 years, this seemingly innocuous and p [...]
POTS stands for Postural Orthostatic Tachycardia Syndrome. This means that patients with this condition find that they feel unwell with symptoms of tremulousness, dizziness and heart palpitations when they stand up. On objective assessment,there is an exaggerated and sustained increase in heart rate (> 30 beats/ per minute in adults; >40 beats per minute in children) compared to when the pat [...]
POTS is a hugely debilitating condition which is characterised by an abnormally high heart rate when the patient adopts an upright posture. A lot of medical research has focused on trying to reduce the heart rate and this does seem to make a beneficial difference in patients with POTS. However virtually every POTS patient that I have looked after will complain of lots of other symptoms which are n [...]
Introduction: Medical care for patients who have a diagnosis of POTS remains hugely unsatisfactory. POTS or rather dysautonomia is a very heterogenous condition. No two people are exactly the same. There is no one single aetiology that can even sometimes be identified. Often the patient who is really suffering looks alright from the outside. Many doctors, largely out of ignorance or perhaps arroga [...]
One of the subjects I have become very interested in POTS. For those who don’t know POTS, it stands for postural orthostatic tachycardia syndrome and is characterised by an excessive increase in heart rate when the patient is upright and this can be extremely unsettling. Along with the racing heart beat, the patient may feel tremulous and dizzy. In addition, patients with POTS have many other symp [...]
