Outcomes of Adolescent-Onset Postural Orthostatic Tachycardia Syndrome

J Pediatr. 2016 Jun:173:149-53. doi: 10.1016/j.jpeds.2016.02.035. Epub 2016 Mar 12.


Objectives: To determine the clinical course of adolescent-onset postural orthostatic tachycardia syndrome (POTS) and to assess health-related quality of life, 2-10 years after diagnosis.

Study design: Pediatric patients, 13-18 years of age, diagnosed with POTS at Mayo Clinic, Rochester, from 2003 to 2010 were mailed a questionnaire if they were at least 18 years of age at the time of the mailing. The primary outcome measures were norm-based, age- and sex-adjusted, 36-Item Short Form Health Survey physical composite score and mental composite score.

Results: The survey was mailed to 502 patients with a response rate of 34% (n = 172). The mean duration from diagnosis to survey completion was 5.4 (SD, 1.9) years; the mean age of the respondents at the time of the survey was 21.8 (2.2) years. The responders were predominantly females (84% vs 68% of nonresponders; P < .001). Only 33 (19%) respondents reported complete resolution of symptoms, and an additional 51% reported persistent but improved symptoms, and 28 (16%) had only intermittent symptoms. The majority (71%) consider their health at least "good." The mean physical composite score was significantly lower than the population norm (mean [SD], 36.6 [15.8] vs 50; P < .001), however, the corresponding mean mental composite score was normal (50.1 [11.2]).

Conclusions: Overall, 86% of adolescents with POTS report resolved, improved, or just intermittent symptoms, when assessed via questionnaire at an average of 5 years after initial treatment. Patients with persistent symptoms have more physical than mental health concerns.

Keywords: autonomic dysfunction; chronic fatigue; dizziness; dysautonomia.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Female
  • Follow-Up Studies
  • Health Status*
  • Humans
  • Male
  • Mental Health
  • Postural Orthostatic Tachycardia Syndrome / physiopathology*
  • Postural Orthostatic Tachycardia Syndrome / therapy
  • Quality of Life*
  • Recurrence
  • Remission, Spontaneous
  • Severity of Illness Index
  • Surveys and Questionnaires
  • Young Adult