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.
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.