The Role of Exercise in the Management of POTS

The Canadian Cardiovascular Society does not recommend pathophysiological subtyping during the initial screening and diagnosis of POTS. Standard investigations for secondary causes include a 12-lead ECG, CBC, electrolytes, renal function, ferritin, thyroid stimulating hormone and a morning cortisol level. A 24-hour halter monitor can exclude significant arrhythmias and may also detect inappropriate sinus tachycardia which is a syndrome that overlaps with POTS. Non-pharmacologic interventions include cessation of contributory medications where possible,. dietary modification to optimize intravascular volume, and semi-recomant aerobic exercise.