(From the November 2013 Issue of MedStat)
POTS in children and adolescents can be difficult to diagnose because of the variety of presenting symptoms. POTS is related to dysfunction of the autonomic nervous system. Patients experience an abnormal increase in heart rate (tachycardia) with position changes, which produces a dizzy spell that sometimes leads to fainting (syncope). Patients with POTS may complain about a variety of symptoms that can include headaches, fatigue, difficulty concentrating, anxiety, nausea and insomnia. Tilt-table testing, sometimes called “head-upright tilt testing,” is a procedure that investigates the causes of dizziness and syncope using a change in posture to elicit symptoms and heart rate and blood pressure changes. The POTS Clinic at Nationwide Children’s is one of only a few neurology programs utilizing tilt-table testing with advanced pediatric expertise. Primary care providers and subspecialists may refer patients with frequent episodes of lightheadedness and other symptoms potentially related to POTS. When at all possible, children and adolescents should be referred to Nationwide Children’s to receive tilt-testing. While other providers offer the test, it is important for it to be performed by those with advanced expertise in pediatrics. Also, insurance providers typically will not approve repeat testing. Please indicate that this is a referral specific to the POTS Clinic and Geoffrey Heyer, MD, when making a referral online, by fax at (614) 722-4000 or by phone at (614) 722-6200. See the insert in your Medical Staff packet for more information regarding POTS.