Postural Orthostatic Tachycardia Syndrome or “POTS” is a clinical syndrome of orthostatic intolerance characterized by a sustained and marked increase in heart rate with little to no change in blood pressure during position changes, plus chronic symptoms of orthostatic intolerance.
The POTS Program within Cardiology at Lurie Children’s provides comprehensive care to patients with cardiovascular symptoms of POTS. Cardiovascular symptoms of POTS include postural tachycardia, dizziness, lightheadedness, exercise intolerance, and near fainting.
In our POTS Program, the primary goals of management are to reduce postural symptoms and enhance overall quality of life. Initial management of symptoms includes non-pharmacologic strategies as a first line of therapy including improved hydration, daily exercise, optimization of nutrition, and withdrawal of medications that can exacerbate orthostatic tachycardia.
Why Choose Lurie Children's?
Our POTS team has created a comprehensive program to support our pediatric POTS patients with a goal of reduction in daily symptoms and increased overall quality of life.
Many pediatric POTS patients avoid exercise altogether due to symptom exacerbation during and following activity. To address this, our POTS team has incorporated a clinical exercise physiologist (CEP) into all of our POTS clinics to highlight the benefit of symptom management with a daily exercise program. As part of our POTS exercise program, our CEP performs an in-depth consultation, evaluation, and an individualized exercise prescription for every patient. Monthly follow-up visits allow us to track compliance and adjust the exercise prescription as patients advance in treatment.
What to Expect
The POTS team will guide your child through the following steps at your child’s initial visit.
Step 1: Check in with Point of Service
Please arrive 15 minutes prior to your child’s appointment time. Please check in at the front desk when you arrive. You may need to scan your insurance card, verify emergency contacts, and sign documents.
Step 2: Vital Signs
After check-in, our team will obtain your child's baseline weight, height, and temperature.
Step 3: Electrocardiogram (ECG/EKG)
An electrocardiogram (EKG or ECG) is one of the simplest and fastest procedures used to evaluate the heart. ECG’s are particularly useful to diagnose arrhythmias, or an irregular heartbeat.
Step 4: Active Stand Test
An active stand test is a simple and non-invasive test used for the diagnosis and management of POTS. During the test, your child will lie down on an exam table for at least 10 minutes to allow their heart rate and blood pressure to stabilize.
Then, your child will stand up quickly and remain standing for 10 minutes. Our team will monitor your child's heart rate and blood pressure at regular intervals during the test and evaluate symptoms.
Step 5: Nursing Intake
The POTS nurse will complete a comprehensive review of your child’s medical history, family history, current medications, daily routine, and symptoms. The POTS nurse will be your child’s care coordinator throughout the entire visit and provide detailed education and an after visit summary of your child’s care plan.
Step 6: POTS Provider
Your child will undergo a thorough evaluation with a POTS provider who specializes in the diagnosis and treatment of POTS. The evaluation will include a detailed review of your child’s medical history and cardiovascular symptoms, a physical examination, and review of diagnostic testing completed during the visit.
If your child meets the strict criteria for POTS, the provider will develop a personalized management plan.
Step 7: Exercise Consultation, Evaluation and Prescription
Your child will undergo an exercise consultation and evaluation with our POTS Clinical Exercise Physiologist (CEP). During the consultation and evaluation, the CEP will start by assessing your child’s functional capacity by completing assessments and symptom surveys.
Then, the CEP will move into a discussion about your child’s current exercise habits, barriers, and overall exercise goals. Finally, the CEP will develop an individualized exercise prescription that is realistic and obtainable to promote the most success for your child’s goals and symptom management.
Step 8: Holter/Event monitor
A Holter monitor, a small device that records your child's heartbeats for 24 hours or longer, allows the provider to see abnormal beats or rhythms that may be causing your child's symptoms.
An event monitor, a 30-day portable heart monitoring device, allows the provider to see abnormal beats or rhythms that may be causing your child's symptoms.
Step 9: Blood Work
Blood tests are commonly performed in POTS clinic as part of the diagnosis and management of POTS. Blood tests can help our providers identify any underlying medical conditions that may be contributing to or exacerbating the symptoms of POTS. For example, blood tests can check for thyroid problems, anemia, or vitamin deficiencies, all of which can affect the autonomic nervous system and contribute to POTS symptoms.
Additional Tests
The POTS team may also recommend the following testing as part of your treatment:
- Echocardiogram: An echocardiogram is a non-invasive, pain-free procedure using sound waves reflected off the surfaces of the heart to provide moving images of your child's heart.
- Cardiopulmonary Exercise Stress Test (CPET): A cardiopulmonary exercise stress test (CPET) measures the heart's response to stress or exercise. An electrocardiogram (ECG) is monitored while your child exercises on a treadmill or stationary bike.
Make an Appointment/Referrals
For New Patients
- If your child or patient is being referred to the POTS Program, they must complete an evaluation with general cardiology and an echocardiogram to exclude structural heart disease before the initial POTS appointment is scheduled.
- Your child or patient must have a current evaluation with a cardiology provider (within Lurie Children's or an outside provider) within the last 12 months.
- If your child or patient does not have a current cardiology provider, then please call 1.800.543.7362 (1.800.KIDS DOC) to schedule an evaluation with a cardiology provider.
- If your child or patient has been seen by an outside cardiology provider within the last 12 months, then please call 1.800.543.7362 (1.800.KIDS DOC) to schedule an appointment in the POTS Program.
- We only accept new patients who are 19 years old or younger.
For Established Patients
To schedule a follow-up visit, please contact our program scheduler at 312.227.4100.
In addition to in-person visits, we now offer telemedicine visits via video, phone and MyChart e-visit. Some appointments will still require you to be seen in-person, but your care team will let you know if a telemedicine appointment is available.
Communication between our providers and families is very important to the work we do. If you have not already, please sign up for MyChart. This is the best way to get in touch with our providers directly to discuss things like new symptoms, questions and changes in medication.
Our Specialists
Jillian M. Myers, MSN, APRN-NP, CPNP-PC
Director, POTS Program
POTS Program Coordinator
Advanced Practice Provider, Outpatient Cardiology
Cassandra M. Raymond, DNP, APRN-NP, FNP-BC
Family Nurse Practitioner, Cardiology
Kendra M. Ward, MD, MSCI
Director, Cardiopulmonary Exercise Lab; Director, Cardiac Rehabilitation Program; Director, Preventive Cardiology Program; Attending Physician, Cardiology
Brittany Holst, MS, CEP, EIM
Lead POTS Clinical Exercise Physiologist
Catherine Moffo, BSN, RN, CPN
POTS Program RN Coordinator
Our Location
Lurie Children's Hospital Outpatient Center in Lincoln Park
2515 N. Clark Street/467 W. Deming PlaceChicago, Illinois 60614-3393
1.800.543.7362
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