Part I - Introduction -- POTS - an introduction -- What is it? -- Historical background -- Clinical presentation -- Specialties where patients may be seen -- Part II - Speciality Assessment -- Cardiological and neurological considerations -- Diagnostic criteria (not just a heart rate issue) -- Pathophysiology and classification -- Tests to consider, are they useful, what do they show -- Cardiological - CPET, echo, holter etc.-Neurological - MRI, nerve conduction studies -- Autonomic -- The simple active stand / tilt -- Full autonomic function tests -- Red flag symptoms -- Cardiology -- Neurology - MS, myopathy, epilepsy -- Overlap conditions (mitral valve prolapse, IST) -- Associated neurological conditions -- Migraine -- Sleep disturbance -- Part III - Associated Conditions -- Rheumatology -- Overlap with hypermobility conditions -- New consensus guidance on hypermobility -- When to consider serious hypermobility -- When to consider other inflammatory arthritides -- Overlap with fibromyalgia and CRPS -- Practical joint management including therapies -- Endocrinology -- What tests should we do to exclude an endocrine driver -- How can we recognise and treat the symptoms of reactive hypoglycaemia -- When do we need to consider referral to endocrinology -- Gastrointestinal manifestations -- Symptoms and causes -- What tests to do to exclude alternative conditions -- Simple and safe treatments that might help -- When to refer to the gastro' clinic -- What treatment is instituted in the specialist clinic? -- Urology / Urogynaecology -- Potential symptoms -- When to consider referral? -- Investigations to consider -- Treatments -- Association with Histamine abnormalities -- Mast cell activation -- What is it? -- When does one consider it? -- What tests to do to define its presence? -- Can we treat it empirically without immunology review -- When to refer -- Audiovestibular medicine -- Recognising vertiginous contributions (migraine variant balance disorder) -- When to refer and what to expect -- Part IV - Relevant Diagnostic Considerations -- Potential alternative causes -- Metabolic issues -- Lyme disease -- Chronic Fatigue syndrome -- Part V - Therapy -- Treatment -- Non-pharmacological - salt, fluid, compression -- Non-pharmacological - exercise -- Pharmacological - when and how to use it -- Midodrine -- Ivabradine -- Betablockers -- Fludrocortisone -- Octreotide -- Pyridostigmine -- Clonidine -- Others e.g. desmopressin, EPO, SSRI, IV fluid -- Assessing benefit -- Part VI - Relevant Therapeutic Associations -- Obstetrics / Gynaecology -- Are there links with endometriosis and PCOS? -- Who should be referred and when? -- Implications for pregnancy and its management -- Pelvic floor issues -- Anaesthetic management -- Anaesthetic considerations in POTS / EDS -- Respiratory medicine -- Hyperventilation is common - why and how to recognise it; why does it occur -- What clinical findings / tests can exclude other conditions -- When to refer to respiratory physio' -- What management can help hyperventilation -- When to consider respiratory medicine review -- Psychological contributors -- Functional symptoms -- Stress responses -- When to involve a psychologist / psychiatrist -- CBT and other therapies -- Part VII - Service Models -- Primary Care -- When to consider referral -- Pointers in the surgery to the diagnosis -- Tests to do first -- Challenges of referral -- Shared-care arrangements -- POTS clinics -- UK models of care KCH, NHNN, Sheffield, Newcastle, William Harvey, Royal Brompton, St Mary's, Poole -- Can you set up your own autonomic tests and how do you do it? -- Nursing aspects -- Developing a nurse led clinic -- Nurse-led follow-up -- Patient aspects -- POTS-UK / STARS -- EDS UK / International HMSA

This book describes the varying clinical manifestations of postural tachycardia syndrome (PoTS) and provides a robust yet practical set of clinical tools for those managing patients suffering with this syndrome. Guidance is provided by a range of disciplines relevant to PoTS including general and specialist assessments, associated conditions, diagnostic considerations, therapy and service models. Postural Tachycardia Syndrome: A Concise and Practical Guide to Management and Associated Conditions presents the scientific background and practical information for the busy medical professional, illustrating key features with care-based materials to help them manage this condition, which can be a challenge for patients and clinicians alike.