Postural orthostatic tachycardia syndrome (POTS) is a chronic and often disabling disorder characterized by orthostatic intolerance with excessive heart rate increase without hypotension during upright posture. Patients often experience a constellation of other typical symptoms including fatigue, exercise intolerance and gastrointestinal distress. A typical patient with POTS is a female of child-bearing age, who often first displays symptoms in adolescence. The onset of POTS may be precipitated by immunological stressors such as a viral infection. A variety of pathophysiologies are involved in the abnormal postural tachycardia response; however, the pathophysiology of the syndrome is incompletely understood and undoubtedly multifaceted.

Clinicians and researchers focused on POTS convened at the National Institutes of Health in July 2019 to discuss the current state of understanding of the pathophysiology of POTS and to identify priorities for POTS research. This article, the first of two articles summarizing the information discussed at this meeting, summarizes the current understanding of this disorder and best practices for clinical care.

The evaluation of a patient with suspected POTS should seek to establish the diagnosis, identify co-morbid conditions, and exclude conditions that could cause or mimic the syndrome. Once diagnosed, management typically begins with patient education and non-pharmacologic treatment options. Various medications are often used to address specific symptoms, but there are currently no FDA-approved medications for the treatment of POTS, and evidence for many of the medications used to treat POTS is not robust.

体位性体位性心动过速综合征 (POTS) 是一种慢性且经常致残的疾病，其特征是体位性不耐受，在直立姿势时心率过度增加而无低血压。患者经常会出现一系列其他典型症状，包括疲劳、运动不耐受和胃肠道不适。典型的 POTS 患者是育龄女性，通常在青春期首次出现症状。POTS 的发作可能是由免疫应激源（如病毒感染）促成的。异常体位性心动过速反应涉及多种病理生理学；然而，该综合征的病理生理学尚不完全清楚，而且无疑是多方面的。

临床医生和研究人员于 2019 年 7 月在美国国立卫生研究院召开了 POTS 会议，讨论了对 POTS 病理生理学的理解现状，并确定了 POTS 研究的优先事项。本文是总结本次会议讨论的信息的两篇文章中的第一篇，总结了目前对该疾病的理解和临床护理的最佳实践。

对疑似 POTS 患者的评估应寻求确定诊断、确定共病情况并排除可能导致或模仿该综合征的情况。一旦确诊，管理通常从患者教育和非药物治疗选择开始。各种药物通常用于解决特定症状，但目前没有 FDA 批准的治疗 POTS 的药物，而且许多用于治疗 POTS 的药物的证据并不可靠。