What is the cause of extreme fatigue, nausea and presyncope in a 16-year-old girl whose ECG shows nonspecific ST changes?
- Postural orthostatic tachycardia syndrome (POTS) is a syndrome of orthostatic intolerance accompanied by symptoms such as faintness, nausea, fatigue and headache.
- POTS commonly occurs after a viral infection, postpartum or after an illness, but it may occur spontaneously.
- About 85% of cases of POTS occur in women, most often aged 15 to 50 years.
- Mild cases may go undiagnosed and it is open to misdiagnosis because POTS is not well known.
- POTS usually resolves over months, but in its more severe form, it may persist for many months to years.
- Treatment is primarily supportive with increasing dietary salt and fluid intake, elevating the head of the bed and avoiding lying down too much.