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Tae Hwan Chung, MD, physician-scientist at Shirley Ryan AbilityLab, recently authored a review article in JAMA about postural orthostatic tachycardia syndrome (POTS).
Dr. Chung is one of the world’s foremost experts on POTS, a chronic autonomic disorder in which patients may experience a rapid heart rate increase (tachycardia) and symptoms such as dizziness, chronic fatigue and brain fog.
Dr. Chung joined Shirley Ryan AbilityLab in 2026 to launch a comprehensive, multidisciplinary POTS and autonomic disorders program. POTS affects as many as 1 to 3 million individuals in the United States, and Dr. Chung hopes to establish the rehabilitation hospital as a global leader in POTS and autonomic medicine to better serve this patient population.
For the JAMA review, Dr. Chung examined existing medical literature about POTS and provided comprehensive observations about the symptoms, diagnosis and management of the condition.
“POTS can substantially impair daily functioning and quality of life for patients, yet obtaining an accurate diagnosis and specialized care remains challenging,” said Dr. Chung. “This review aims to provide physicians who may be less familiar with POTS a practical guide to recognizing the condition, making the diagnosis and helping patients manage their symptoms.”
Key Takeaways
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- POTS is characterized by chronic symptoms of “orthostatic intolerance,” meaning patients may develop symptoms when they move into an upright position, like standing up.
- Patients with POTS may experience an increased heart rate, heart palpitations, fatigue, lightheadedness, gastrointestinal issues, generalized weakness and muscle pain — without having other cardiovascular, GI or neurological conditions.
- Approximately 90% of patients with POTS are female, with peak incidence from ages 13 to 29. However, POTS’ true prevalence is uncertain because the condition is often underdiagnosed and has only recently received a specific ICD-10 diagnostic code.
- In a survey reviewed by Dr. Chung for the JAMA article, approximately 70% of patients with POTS reported experiencing substantial functional impairment and loss of school or work participation. The survey also found that it typically took patients about two years to receive a POTS diagnosis.
- In 30-40% of POTS cases, symptoms began within three months after infections (e.g., COVID-19, Epstein-Barr virus and influenza).
- Recommended first-line treatment for POTS is nonpharmacological measures, such as increased fluid and sodium intake; wearing lower-body compression garments; and participating in structured, supervised aerobic training, such as via rehabilitation therapy. Patients also should avoid heat exposure, dehydration and prolonged standing to mitigate their symptoms. They may further benefit from medication tailored to their needs.
Visit JAMA to read the POTS review abstract; a subscription is required for the full article.
