POTS Clinic

At Atrium Health Sanger Heart & Vascular Institute, Gragg Center for Cardiovascular Performance, we specialize in the diagnosis and management of Postural Orthostatic Tachycardia Syndrome (POTS).

Conditions Treated

Postural Orthostatic Tachycardia Syndrome (POTS) is a disorder characterized by an abnormal increase in heart rate with standing. POTS is associated with symptoms such as dizziness, passing out and fatigue. However, POTS can present differently in each patient, so our team of experts work to create unique, multidisciplinary solutions for optimal management of your condition.

POTS is a clinical syndrome characterized by:

• Heart rate increase with standing: A sustained increase in heart rate of ≥ 30 bpm within 10 min of standing (≥40 bpm for individuals aged 12–19), or a heart rate >120 bpm within 10 minutes of standing.
• Presence of postural symptoms: Symptoms that occur frequently upon standing and have been present for ≥6 months. These may include lightheadedness, near fainting, palpitations, fatigue, and cognitive dysfunction.
• Absence of orthostatic hypotension: There should be no significant drop in blood pressure (≥20 mmHg systolic or ≥10 mmHg diastolic) upon standing.
• Exclusion of other conditions: Other causes of a fast heart rate (e.g., anemia, dehydration, hyperthyroidism, medications, or deconditioning) have been ruled out.

Why Choose Us?

• Nationally Recognized: At Sanger Heart & Vascular Institute (SHVI), our care has repeatedly earned national recognition, including top ratings from U.S. News & World Report. 
• Expert Team: We offer an experienced team of experts who specialize in the diagnosis and treatment of Postural Orthostatic Tachycardia Syndrome (POTS). Our team closely works alongside other specialties to provide comprehensive, coordinated care.
• State-of-the-art imaging: SHVI has among the nation’s highest volumes of advanced imaging capabilities, vascular ultrasounds, cardiac CTs, MRIs and echocardiograms, which means you get quicker access to diagnostic information and prompt treatment decisions.

Team Approach

POTS patients often experience other chronic symptoms that require co-management, we offer specialized referrals to provide you with optimal care with other subspecialties.

Conditions Outside the Scope of this Clinic:

• Primary orthostatic hypotension
• Neurogenic causes of orthostatic intolerance
• Isolated vasovagal syncope without features of POTS
• Autonomic failure/dysfunction without POTS
• Broader dysautonomia syndromes without clear POTS features

Note: Not all dysautonomia is POTS. Dysautonomia encompasses a broad spectrum of disorders, and our clinic focuses specifically on those consistent with POTS diagnostic criteria.

What to Expect from Your Appointment

From diagnosis and monitoring to treatment and follow-up, we oversee every aspect of your care. Here’s what you can expect before, during, and after your first appointment.

• Before your appointment: We will request your medical records, including your medical history, test results and images (like an echocardiogram). You may have imaging/testing arranged prior to your first visit. We will also reach out to give you information about your care plan and upcoming appointments.
• During your appointment: You will meet with an advanced practice provider with expertise in POTS who will perform a detailed review of your clinical history and current symptoms. Detailed orthostatic vital signs will be performed, and we will review imaging/testing results. We will then determine if additional diagnostic testing is needed and create an appropriate care plan.
• After your appointment: Once testing/diagnostics are complete, we will review results in depth, make referrals to other specialties and continue to tailor a care plan specific to your individual needs.

Make a Referral

EPIC Referrals: Amb Referral to Adult Cardiology

Reason for Referral: POTS