Adult Criteria for Diagnosis for POTS Are Not Appropriate in Children

Normative data show that the adult diagnostic criterion of a rise in orthostatic heart rate ≥30 beats per minute is within the normal range in children.

Postural orthostatic tachycardia syndrome (POTS) is being recognized with increasing frequency in children and adolescents (JW Pediatr Adolesc Med Mar 2 2011). Diagnosis is based on adult criteria of a rise in heart rate (HR) ≥30 beats per minute (bpm) within 5 minutes after tilt-table testing. Investigators compared orthostatic change in HR after tilt testing in 106 normal children (age range, 8–19 years) and 654 similarly aged patients who had been referred to a clinical autonomic laboratory for orthostatic intolerance or POTS.

The HR increment within 5 minutes after tilt testing was significantly greater in patients than in controls (32±14 vs. 27±13 bpm). However, 42% of controls (and 55% of patients) had orthostatic HR increases ≥30 bpm.…

Reviewing Author

F. Bruder Stapleton, MD

Disclosures

Consultant/Advisory BoardCareer Physician

Editorial BoardsUpToDate

Leadership Positions in Professional SocietiesAmerican Society of Pediatric Nephrology Foundation (Chair)

F. Bruder Stapleton, MD

Disclosures

Consultant/Advisory BoardCareer Physician

Editorial BoardsUpToDate

Leadership Positions in Professional SocietiesAmerican Society of Pediatric Nephrology Foundation (Chair)