{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:37:39Z","timestamp":1787017059176,"version":"build-2736575974"},"reference-count":42,"publisher":"BMJ","issue":"9","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2019,8,28]]},"published-print":{"date-parts":[[2019,9]]},"abstract":"<jats:p>Postural orthostatic tachycardia syndrome (POTS) is a heterogeneous autonomic disorder characterised by orthostatic intolerance and a rise in heart rate by at least 30 bpm or an absolute heart rate value of at least 120 bpm within 10\u2009min of standing or during a tilt table test. Overwhelmingly, POTS affects young Caucasian women, which can lead physicians to miss the diagnosis in men or non-white patients. We describe a case of 29-year-old African-American man who developed lightheadedness, generalised weakness, tachycardia and palpitations and was subsequently diagnosed with POTS. We review its clinical features, differential diagnosis, pathophysiology and treatment options. We also emphasise that POTS should be considered as a differential diagnosis in any patient presenting with typical clinical features, who may not be in the usual demographics of the disorder.<\/jats:p>","DOI":"10.1136\/bcr-2019-229824","type":"journal-article","created":{"date-parts":[[2019,9,19]],"date-time":"2019-09-19T07:25:14Z","timestamp":1568877914000},"page":"e229824","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":8,"title":["Postural orthostatic tachycardia syndrome in primary care: diagnosis, treatment and a case of African-American man presenting with POTS"],"prefix":"10.1136","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6049-7990","authenticated-orcid":false,"given":"Andrew T","family":"Del Pozzi","sequence":"first","affiliation":[{"name":"Department of Kinesiology, Ball State University, Muncie, Indiana, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Enechukwu","sequence":"additional","affiliation":[{"name":"Department of Medicine, State University of New York Upstate Medical University College of Medicine, Syracuse, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Svetlana","family":"Blitshteyn","sequence":"additional","affiliation":[{"name":"Department of Neurology, State University of New York at Buffalo School of Medicine and Biomedical Sciences, Buffalo, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2019,9,18]]},"reference":[{"key":"2025082702560838000_12.9.e229824.1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.111.965343"},{"key":"2025082702560838000_12.9.e229824.2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000160356.97313.5D"},{"key":"2025082702560838000_12.9.e229824.3","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-104-3-298"},{"key":"2025082702560838000_12.9.e229824.4","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9343(97)00133-2"},{"key":"2025082702560838000_12.9.e229824.5","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2010.11.009"},{"key":"2025082702560838000_12.9.e229824.6","doi-asserted-by":"publisher","DOI":"10.1046\/j.1540-8167.2005.04441.x"},{"key":"2025082702560838000_12.9.e229824.7","doi-asserted-by":"publisher","DOI":"10.1152\/ajpheart.01217.2010"},{"key":"2025082702560838000_12.9.e229824.8","doi-asserted-by":"publisher","DOI":"10.1152\/ajpheart.01211.2010"},{"key":"2025082702560838000_12.9.e229824.9","doi-asserted-by":"crossref","first-page":"1211","DOI":"10.1093\/europace\/euw154","article-title":"Antiadrenergic autoimmunity in postural tachycardia syndrome","volume":"19","author":"Fedorowski","year":"2017","journal-title":"Europace"},{"key":"2025082702560838000_12.9.e229824.10","doi-asserted-by":"publisher","DOI":"10.1016\/j.autneu.2018.04.005"},{"key":"2025082702560838000_12.9.e229824.11","doi-asserted-by":"publisher","DOI":"10.1177\/0961203316629558"},{"key":"2025082702560838000_12.9.e229824.12","doi-asserted-by":"publisher","DOI":"10.1177\/0961203315587566"},{"key":"2025082702560838000_12.9.e229824.13","doi-asserted-by":"publisher","DOI":"10.1016\/j.mayocp.2012.08.013"},{"key":"2025082702560838000_12.9.e229824.14","doi-asserted-by":"publisher","DOI":"10.1136\/pgmj.2006.055046"},{"key":"2025082702560838000_12.9.e229824.15","doi-asserted-by":"crossref","first-page":"668","DOI":"10.1017\/S1047951117002888","article-title":"Demographics of a large paediatric Postural Orthostatic Tachycardia Syndrome Program","volume":"28","author":"Boris","year":"2018","journal-title":"Cardiol Young"},{"key":"2025082702560838000_12.9.e229824.16","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1016\/j.autneu.2018.06.002","article-title":"The patient perspective: What postural orthostatic tachycardia syndrome patients want physicians to know","volume":"215","author":"Stiles","year":"2018","journal-title":"Auton Neurosci"},{"key":"2025082702560838000_12.9.e229824.17","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.43.1_Part_1.132"},{"key":"2025082702560838000_12.9.e229824.18","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.107.761643"},{"key":"2025082702560838000_12.9.e229824.19","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2011.08.054"},{"key":"2025082702560838000_12.9.e229824.20","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.159.4.375"},{"key":"2025082702560838000_12.9.e229824.21","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.160.11.1573"},{"key":"2025082702560838000_12.9.e229824.22","first-page":"66","article-title":"postural stability, and symptoms after dehydration","volume":"42","author":"Patel","year":"2007","journal-title":"J Athl Train"},{"key":"2025082702560838000_12.9.e229824.23","doi-asserted-by":"publisher","DOI":"10.1002\/ana.10556"},{"key":"2025082702560838000_12.9.e229824.24","doi-asserted-by":"publisher","DOI":"10.2337\/dc10-1303"},{"key":"2025082702560838000_12.9.e229824.25","doi-asserted-by":"publisher","DOI":"10.1001\/jama.279.3.217"},{"key":"2025082702560838000_12.9.e229824.26","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200806-953OC"},{"key":"2025082702560838000_12.9.e229824.27","doi-asserted-by":"publisher","DOI":"10.1176\/ajp.145.12.1564"},{"key":"2025082702560838000_12.9.e229824.28","doi-asserted-by":"publisher","DOI":"10.1016\/j.brat.2004.08.008"},{"key":"2025082702560838000_12.9.e229824.29","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1016\/j.autneu.2018.04.008","article-title":"Pharmacotherapy for postural tachycardia syndrome","volume":"215","author":"Miller","year":"2018","journal-title":"Auton Neurosci"},{"key":"2025082702560838000_12.9.e229824.30","doi-asserted-by":"crossref","unstructured":"Schofield JR , Chemali KR . Intravenous Immunoglobulin Therapy in Refractory Autoimmune Dysautonomias: A Retrospective Analysis of 38 Patients. Am J Ther 2018.doi:10.1097\/MJT.0000000000000778","DOI":"10.1097\/MJT.0000000000000778"},{"key":"2025082702560838000_12.9.e229824.31","doi-asserted-by":"crossref","first-page":"401","DOI":"10.1086\/687757","article-title":"Postural tachycardia syndrome is not caused by deconditioning","volume":"6","author":"Blitshteyn","year":"2016","journal-title":"Pulm Circ"},{"key":"2025082702560838000_12.9.e229824.32","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1016\/B978-0-444-53491-0.00013-4","article-title":"Exercise and the autonomic nervous system","volume":"117","author":"Fu","year":"2013","journal-title":"Handb Clin Neurol"},{"key":"2025082702560838000_12.9.e229824.33","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.111.172262"},{"key":"2025082702560838000_12.9.e229824.34","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1016\/j.autneu.2018.07.001","article-title":"Exercise and non-pharmacological treatment of POTS","volume":"215","author":"Fu","year":"2018","journal-title":"Auton Neurosci"},{"key":"2025082702560838000_12.9.e229824.35","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1007\/s10840-017-0225-y","article-title":"Effects of intermittent intravenous saline infusions in patients with medication-refractory postural tachycardia syndrome","volume":"48","author":"Ruzieh","year":"2017","journal-title":"J Interv Card Electrophysiol"},{"key":"2025082702560838000_12.9.e229824.36","unstructured":"Blitshteyn S . Postural tachycardia syndrome and anxiety disorders. Journal of Neurology, Neurosurgery and Psychiatry 2009;80."},{"key":"2025082702560838000_12.9.e229824.37","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1016\/j.autneu.2018.03.004","article-title":"Cognitive and psychological issues in postural tachycardia syndrome","volume":"215","author":"Raj","year":"2018","journal-title":"Auton Neurosci"},{"key":"2025082702560838000_12.9.e229824.38","doi-asserted-by":"crossref","unstructured":"Stiles L , Shaw BH , Green EA , et al . Sensory Neuropathic Symptoms in Postural Tachycardia Syndrome: Insights from a Cross-Sectional Community-Based Survey (P5.322). Neurology 2017;88. 16 Supplement.","DOI":"10.1212\/WNL.88.16_supplement.P5.322"},{"key":"2025082702560838000_12.9.e229824.39","doi-asserted-by":"publisher","DOI":"10.1007\/s10620-014-3514-7"},{"key":"2025082702560838000_12.9.e229824.40","doi-asserted-by":"publisher","DOI":"10.1136\/ard.53.5.293"},{"key":"2025082702560838000_12.9.e229824.41","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1161\/01.HYP.38.1.76","article-title":"Transepithelial sodium absorption is increased in people of African origin","volume":"38","author":"Baker","year":"2001","journal-title":"Hypertension"},{"key":"2025082702560838000_12.9.e229824.42","doi-asserted-by":"publisher","DOI":"10.1097\/MAJ.0000000000000308"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2019-229824","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T09:56:57Z","timestamp":1756288617000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2019-229824"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,9]]},"references-count":42,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2019,9,18]]},"published-print":{"date-parts":[[2019,9]]}},"alternative-id":["10.1136\/bcr-2019-229824"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2019-229824","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,9]]}}}