Evaluation of postural tachycardia syndrome (POTS).

This article by Brent P. Goodman discusses the comprehensive diagnostic evaluation necessary for accurately identifying postural orthostatic tachycardia syndrome (POTS). It emphasizes the importance of taking a thorough patient history and conducting a detailed clinical examination that includes assessing pupillary responses, sudomotor and vasomotor signs, and joint hypermobility. Laboratory testing is crucial to rule out other conditions that mimic autonomic dysfunction, identify symptom exacerbating factors, and discover associated conditions. Autonomic testing is essential for confirming POTS, differentiating it from other forms of orthostatic intolerance, and distinguishing between POTS subtypes, like neuropathic and hyperadrenergic. Additional diagnostic studies may include skin punch biopsy, exercise testing, and others, depending on the patient's clinical presentation.