Pediatric Heart Expert Forum
POTS help
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Questions in this forum are answered by pediatric cardiologists, cardiothoracic surgeons and anesthesiologists from The Children's Hospital of Philadelphia. This forum is for questions and support about pediatric heart problems, symptoms and topics such as heart murmurs, palpitations, fainting, chest pain, congenital heart defects (including management and intervention), fetal cardiology, adult congenital cardiology, arrhythmias and pre-participation athletic screening.

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POTS help

I have been counting down the days until we meet Dr. Boris for an evaluation.  My daughter has many of the symptoms of POTS and I have done a considerable amount of online research.  What if she is having a "good day" when we see you four days from now?  Can you still make an accurate diagnosis without the tilt table, norepinephrine and blood volume levels?  If she does have POTS, can she still do gymnastics?  She loves milk; would she have to stop drinking it?  Thank you in advance.
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773637_tn?1327450515
Dear Surry Girl,

Even if she is having a "good" day, the history associated with postural orthostatic tachycardia syndrome (POTS) is often a reasonable giveaway.  Also, these patients still typically have a jump of at least 30 beats per minute in their heart rate from lying down to standing up, even if they're feeling well.  I typically do not perform tilt table testing or laboratory studies to confirm the diagnosis.

For physical activity, many of the recommendations are dependent upon how the patient is doing after therapy has been started.  I have had patients return to sports without problems.  I have had others who will feel good, exercise on one day, and be wiped out for the next 3 days.  Everyone responds differently, and it is not easy to predict.

Regarding what to drink with POTS, as you may know, it is helpful for these patients to drink 60 to 80 ounces of fluid per day.  That can be water, milk, or juice.  I have had a few patients improve some of their symptoms after elimination of dairy products, but most do not demonstrate a difference.

I look forward to meeting you in clinic.
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773637_tn?1327450515
Jeffrey R Boris, M.D.Blank
The Children’s Hospital of Philadelphia
Philadelphia, PA
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