Take this to your appointment.

What to bring

Doctors decide faster with data. Bring numbers along with your story.

• Two to four stand tests from different mornings (lying heart rate, standing heart rate at 1, 3, 5 and 10 minutes)
• Blood pressure lying down and at 3 minutes standing, if you have a cuff
• A symptom diary: when symptoms start, what you were doing, how long they last, what helped
• A list of every medicine, supplement, caffeine and nicotine product, with doses
• When symptoms began and anything that came before: infection, surgery, pregnancy, concussion, rapid growth
• Past test results (blood work, ECGs, heart monitors) and the names of doctors you have seen
• Family history of fainting, rhythm problems, joint hypermobility or autoimmune disease

Tests to ask whether you need

Published reviews list these. Your doctor decides which ones fit. See the tests guide for the reasons.

• A 10-minute active stand test or tilt table with heart rate and blood pressure at set minutes
• 12-lead ECG
• Blood count (anemia), electrolytes and kidney function, ferritin, thyroid (TSH)
• Morning cortisol, if adrenal problems are a possibility
• A rhythm monitor, if palpitations happen while lying or sitting, or start and stop abruptly
• Echocardiogram, if a murmur or structural heart disease is a concern
• A review of medicines that can raise heart rate (stimulants, decongestants, some antidepressants)

Questions to ask

• Do my numbers meet the criteria for POTS, and what else could explain them?
• Which look-alike conditions have you ruled out, and which are left?
• What non-drug measures should I start now: fluids, salt, compression, exercise?
• Is salt safe for me given my blood pressure and kidneys?
• If we try a medicine, what are we aiming to improve, how will we judge it, and when do we reassess?
• Could any of my current medicines make this worse?
• How should I exercise safely, and can you refer me to a supervised program?
• Which symptoms mean I should call you or go to the emergency department?
• What should I ask my school or employer for, and can you write a letter?
• Do I need a referral to cardiology, neurology or an autonomic clinic?
• How often should I repeat stand tests at home, and what change would matter to you?