Testing & Diagnosis

 

Diagnostic criteria

The only test that can diagnose POTS is a Tilt Table Test*
*also referred to as an autonomic function test

A heart rate increase from horizontal to standing (or as tested on a tilt table) of at least 30 beats per minute in adults, or at least 40 beats per minute in adolescents, measured during the first 10 minutes of standing plus monitored symptoms.

& an absence of significant orthostatic hypotension (magnitude of blood pressure drop ≥ 20/10 mm Hg).

Source Hopkins Medical

POTS is often diagnosed by a Tilt Table Test, but if such testing is not available, POTS can be diagnosed with an at-home tilt test” often referred to as “A Poor Man’s Tilt Test” (bedside measurements of heart rate and blood pressure taken in the supine (laying down) and standing up position at 2, 5 and 10 minute intervals).
Source Dysautonomia International

POTS & other types of Dysautonomias are not diagnosable by

  • EKG

  • Blood pressure

  • Bloodwork or urine

Those sorts of tests can potentially help rule out other disorders or can confirm a POTS subtype, but they are not the way to diagnose POTS.

Is it possible to do the Tilt Test at home?

Yes, you can do a variation at home

You’ll need heart rate monitor such as a Fitbit/Apple watch, Blood pressure device, or Oximeter. Many POTS specialists consider this valid for treatment.

POTS disorder brochure diagnostic criteria and summary

Other tests your doctor may order

  • EKG

  • 1-30 day holtor monitor

  • 24 hour blood pressure monitor

  • QSART (usually included in a formal tilt test)

  • TST

  • Gastric emptying study to check for Gastroparesis

  • Nerve biopsies to check for Small Fiber Neuropathy

  • Catecholamines for HyperPOTS (not 100% accurate)

Source Cleveland Clinic

What is not considered POTS diagnostic criteria

  • Fainting: People with the adrenaline subtype often never faint

  • Dizziness: Some people with the adrenaline subtype often never get dizzy or lightheaded

  • Blood pressure changes: This is taken into account and can help diagnose subtypes, but it is not a part of diagnostic criteria

  • Gender: Boys & men can get POTS

  • Age: People of any age can get it. You cannot be too young or old

  • Appearance: It doesn’t matter what a person looks like, they can have POTS