The DOI matches its Crossref record; 77 of the 78 references it cites were found in a registry or an index; 7 of the 113 sources its claims cite were checked for support.
Postural Tachycardia Syndrome: Beyond Orthostatic Intolerance
Open accessAbstract
Postural tachycardia syndrome (POTS) is a form of chronic orthostatic intolerance for which the hallmark physiological trait is an excessive increase in heart rate with assumption of upright posture. The orthostatic tachycardia occurs in the absence of orthostatic hypotension and is associated with a >6-month history of symptoms that are relieved by recumbence. The heart rate abnormality and orthostatic symptoms should not be caused by medications that impair autonomic regulation or by debilitating disorders that can cause tachycardia. POTS is a "final common pathway" for a number of overlapping pathophysiologies, including an autonomic neuropathy in the lower body, hypovolemia, elevated sympathetic tone, mast cell activation, deconditioning, and autoantibodies. Not only may patients be affected by more than one of these pathophysiologies but also the phenotype of POTS has similarities to a number of other disorders, e.g., chronic fatigue syndrome, Ehlers-Danlos syndrome, vasovagal syncope, and inappropriate sinus tachycardia. POTS can be treated with a combination of non-pharmacological approaches, a structured exercise training program, and often some pharmacological support.
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Claims the paper makes
82 Not checked yet · 7 Own interpretation · 2 Supported · 1 Partly supported · 1 Mixed support · accuracy not yet measured
Some cited sources support this claim and some don’t — read each source’s verdict below.
In the paper
“Some POTS patients with hypovolemia, however, have inappropriately low standing plasma renin activity and aldosterone compared with normovolemic controls [46;12].”
§ Postural Tachycardia Syndrome: Beyond Orthostatic Intolerance > Pathophysiology of POTS > Hypovolemia and the Renin-Angiotensin-Aldosterone System in POTS
What the sources say
- Supportedcites [46] Raj SR, Biaggioni I, Yamhure PC, Black BK, Paranjape SY, Byrne DW, et al. Renin-aldosterone paradox and perturbed blood volume regulation underlying postural tachycardia syndrome. Circulation. 2005;111:1574–82. source
The Renin and Aldosterone section reports similar standing plasma renin activity in POTS patients and controls, but significantly lower upright aldosterone in the POTS group. The Renin-Aldosterone Paradox section explains that, given the patients’ hypovolemia, both values were inappropriately low: renin was low relative to the expected compensatory increase, not lower than the control value. (LLM, conf=0.92)
- Disputedcites [12] Fu Q, Vangundy TB, Shibata S, Auchus RJ, Williams GH, Levine BD. Menstrual cycle affects renal-adrenal and hemodynamic responses during prolonged standing in the postural orthostatic tachycardia syndrome. Hypertension. 2010;56:82–90. sourceExperimental — accuracy not yet measured
The Results (POTS versus Controls) report lower plasma volume in POTS women, but greater standing plasma renin activity and no between-group difference in aldosterone. The Discussion (RAAS Responses in POTS) reiterates those findings. Although the Introduction notes that earlier studies reported decreased renin and/or aldosterone, this paper's comparison does not show both to be low. (LLM, conf=0.88)
Checked by a reasoning model — may be wrong.
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
In the paper
“Yet a structured evaluation using criteria from the Diagnostic and Statistical Manual (fourth edition, text revision) did not identify a higher incidence of major depressive disorder, anxiety disorders, or substance abuse in POTS patients than the general population [27].”
§ Postural Tachycardia Syndrome: Beyond Orthostatic Intolerance > Clinical Presentation of POTS > Psychological Profile in POTS
What the sources say
- Not checked yetcites [27] Raj V, Haman KL, Raj SR, Byrne D, Blakely RD, Biaggioni I, et al. Psychiatric profile and attention deficits in postural tachycardia syndrome. J Neurol Neurosurg Psychiatry. 2009;80:339–44. source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Furthermore, the HR increase in patients is not a response to anxiety [28].”
§ Postural Tachycardia Syndrome: Beyond Orthostatic Intolerance > Clinical Presentation of POTS > Psychological Profile in POTS
What the sources say
- Not checked yetcites [28] Masuki S, Eisenach JH, Johnson CP, Dietz NM, Benrud-Larson LM, Schrage WG, et al. Excessive heart rate response to orthostatic stress in postural tachycardia syndrome is not caused by anxiety. J Appl Physiol (1985). 2007;102:896–903. source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“The orthostatic tachycardia of POTS is exaggerated in the morning compared to the evening.”
§ Postural Tachycardia Syndrome: Beyond Orthostatic Intolerance > Clinical Presentation of POTS > Diagnostic Criteria
What the sources say
- Not checked yetcites [18] Brewster JA, Garland EM, Biaggioni I, Black BK, Ling JF, Shibao CA, et al. Diurnal variability in orthostatic tachycardia: implications for the postural tachycardia syndrome. Clin Sci (Lond). 2012;122:25–31. source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“The tachycardia of POTS is a sinus tachycardia.”
§ Postural Tachycardia Syndrome: Beyond Orthostatic Intolerance > Clinical Presentation of POTS > Common Clinical Features
What the sources say
- Not checked yetcites [11] Johnson JN, Mack KJ, Kuntz NL, Brands CK, Porter CJ, Fischer PR. Postural orthostatic tachycardia syndrome: a clinical review. Pediatr Neurol. 2010;42:77–85. source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“POTS is a “final common pathway” for a number of overlapping pathophysiologies, including an autonomic neuropathy in the lower body, hypovolemia, elevated sympathetic tone, mast cell activation, deconditioning, and autoantibodies.”
§ Postural Tachycardia Syndrome: Beyond Orthostatic Intolerance > Abstract
What the sources say
- Not checked yetcites [2] Raj SR. The postural tachycardia syndrome (POTS): pathophysiology, diagnosis & management. Indian Pacing Electrophysiol J. 2006;6:84–99.
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“POTS is not considered to be a unique disease but rather the common phenotype of a number of heterogeneous, overlapping pathophysiological processes [2].”
§ Postural Tachycardia Syndrome: Beyond Orthostatic Intolerance > Introduction
What the sources say
- Not checked yetcites [2] Raj SR. The postural tachycardia syndrome (POTS): pathophysiology, diagnosis & management. Indian Pacing Electrophysiol J. 2006;6:84–99.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“These data suggest that the impaired health-related quality of life measured in POTS can be attributed significantly to sleep problems [5].”
§ Postural Tachycardia Syndrome: Beyond Orthostatic Intolerance > Disorders Overlapping with POTS > Chronic Fatigue Syndrome (CFS)
What the sources say
- Not checked yetcites [5] Bagai K, Song Y, Ling JF, Malow B, Black BK, Biaggioni I, et al. Sleep disturbances and diminished quality of life in postural tachycardia syndrome. J Clin Sleep Med. 2011;7:204–10. source
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“In POTS, the orthostatic change in HR surpasses that in IST.”
§ Postural Tachycardia Syndrome: Beyond Orthostatic Intolerance > Disorders Overlapping with POTS > Inappropriate Sinus Tachycardia (IST)
What the sources say
- Not checked yetcites [41] Nwazue VC, Paranjape SY, Black BK, Biaggioni I, Diedrich A, Dupont WD, et al. Postural tachycardia syndrome and inappropriate sinus tachycardia: role of autonomic modulation and sinus node automaticity. J Am Heart Assoc. 2014;3:e000700. This physiological study used intrinsic heart rate testing to determine the relative autonomic contributions vs. intrinsic heart pacemaker abnormalities in POTS and inappropriate sinus tachycardia (IST). Intrinsic heart rate was not different from controls for either POTS or IST. IST patients had more sympathetic tone and less parasympathetic tone than POTS pat source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Plasma renin activity and aldosterone tended to be higher in patients with CFS.”
§ Postural Tachycardia Syndrome: Beyond Orthostatic Intolerance > Disorders Overlapping with POTS > Chronic Fatigue Syndrome (CFS)
What the sources say
- Not checked yetcites [33] Okamoto LE, Raj SR, Peltier A, Gamboa A, Shibao C, Diedrich A, et al. Neurohumoral and haemodynamic profile in postural tachycardia and chronic fatigue syndromes. Clin Sci (Lond). 2012;122:183–92. source
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- It may state two separate claims as one. 43
- Probably not a substantial claim. 16
Every source the paper cites for this claim was checked and supports it.
In the paper
“Compensatory sympathetic activation to maintain adequate vasoconstriction could then induce tachycardia via β-ARs. β1-AR- and β2-AR-activating autoantibodies could also contribute to the tachycardia.”
§ Postural Tachycardia Syndrome: Beyond Orthostatic Intolerance > Pathophysiology of POTS > Autoimmune/Autoantibodies
What the sources say
- Supportedcites [57] Li H, Yu X, Liles C, Khan M, Vanderlinde-Wood M, Galloway A, et al. Autoimmune basis for postural tachycardia syndrome. J Am Heart Assoc. 2014;3:e000755. This study found the presence of partial agonist alpha-1 adrenergic antibodies and agonist beta-adrenergic autoantibodies in a high percentage of POTS patients. While preliminary, these data suggest a mechanism to explain the relatively common onset of POTS after a viral-like illness. source
The Introduction describes impaired vasoconstriction prompting increased sympathetic activity, with an exaggerated β1AR-mediated tachycardia; it adds that β1/2AR-activating autoantibodies could enhance it. The Discussion likewise describes compensatory sympathetic outflow and says β1AR and β2AR autoantibodies would heighten cardiac responsiveness. (LLM, conf=0.94)
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“The three-month Dallas Program, which involves aerobic exercise coupled with resistance training, improves orthostatic and exercise tachycardia, symptoms, and quality of life [13;62;63].”
§ Postural Tachycardia Syndrome: Beyond Orthostatic Intolerance > Treatment of POTS (Table 2) > Non-Pharmacological Treatment of POTS
What the sources say
- Partly supportedcites [13] Fu Q, Vangundy TB, Galbreath MM, Shibata S, Jain M, Hastings JL, et al. Cardiac origins of the postural orthostatic tachycardia syndrome. J Am Coll Cardiol. 2010;55:2858–68. sourceExperimental — accuracy not yet measured
The Methods (Exercise training) describe a three-month program combining endurance and resistance training. The Results (Exercise training effects) report lower standing heart rate and improved quality of life, and the Limitations discuss improvements in POTS symptoms. Our copy reports improved exercise capacity, but not reduced tachycardia during exercise; it also cautions that symptom improvements cannot be attributed solely to training because patients were encouraged to make other changes. (LLM, conf=0.86)
- Partly supportedcites [62] Fu Q, Vangundy TB, Shibata S, Auchus RJ, Williams GH, Levine BD. Exercise training versus propranolol in the treatment of the postural orthostatic tachycardia syndrome. Hypertension. 2011;58:167–75. sourceExperimental — accuracy not yet measured
The Methods describe a three-month program combining endurance exercise and resistance training. The Results report lower standing heart rate and improved quality of life, and the Perspectives report improved POTS symptoms. Our copy does not report whether tachycardia during exercise improved; the exercise test described in Methods was performed before training. (LLM, conf=0.86)
- Partly supportedcites [63] Shibata S, Fu Q, Bivens TB, Hastings JL, Wang W, Levine BD. Short-term exercise training improves the cardiovascular response to exercise in the postural orthostatic tachycardia syndrome. J Physiol. 2012;590:3495–505. sourceExperimental — accuracy not yet measured
The Methods (page unavailable) describe a three-month programme combining endurance exercise and resistance training. The Abstract reports a lower heart rate at a given exercise intensity after training, and the Discussion says orthostatic tachycardia had improved, citing an earlier study. This paper does not report improvements in symptoms or quality of life. (LLM, conf=0.87)
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Partly supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“Vasovagal syncope and POTS overlap clinically, and both diagnoses may be appropriate for a given patient [8].”
§ Postural Tachycardia Syndrome: Beyond Orthostatic Intolerance > Disorders Overlapping with POTS > Vasovagal Syncope (VVS)
What the sources say
- Supportedcites [8] Sheldon RS, Grubb BP, Olshansky B, Shen WK, Calkins H, Brignole M, et al. 2015 heart rhythm society expert consensus statement on the diagnosis and treatment of postural tachycardia syndrome, inappropriate sinus tachycardia, and vasovagal syncope. Heart Rhythm. 2015;12:e41–63. The Heart Rhythm Society has recently published its first consensus statement on the diagnosis and treatment of postural tachycardia syndrome (POTS) and other disorders. While not comprehensive, it provides an excellent starting point for a clinician wanting to learn about the management of POTS. source
The POTS Definition section says that many patients with POTS faint occasionally and explicitly states that POTS and vasovagal syncope diagnoses are not mutually exclusive. This supports both clinical overlap and the possibility of both diagnoses in one patient. (LLM, conf=0.94)
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Supported
In the paper
“Chest pain in POTS is rarely from coronary artery obstruction but it may be associated with ECG changes when patients are upright [20].”
§ Postural Tachycardia Syndrome: Beyond Orthostatic Intolerance > Clinical Presentation of POTS > Common Clinical Features
What the sources say
- Not checked yetcites [20] Friesinger GC, Biern RO, Likar I, Mason RE. Exercise electrocardiography and vasoregulatory abnormalities. Am J Cardiol. 1972;30:733–40. source
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Postural Tachycardia Syndrome (POTS) is a form of chronic orthostatic intolerance for which the hallmark physiological trait is an excessive increase in heart rate with assumption of upright posture.”
- Also stated in: § Introduction · plain
“An expert consensus statement [1] defines POTS as a HR increment ≥30 beats/min within 10 minutes of standing or head-up-tilt (HUT) which is sustained in the absence of orthostatic hypotension (a drop >20 mmHg in systolic blood pressure [BP] or >10mmHg in diastolic BP).”
- Also stated in: § Introduction · plain
“Patients with POTS experience cardiac and non-cardiac presyncopal symptoms chronically (≥6 months).”
§ Postural Tachycardia Syndrome: Beyond Orthostatic Intolerance > Abstract
What the sources say
- Not checked yetcites [1] Freeman R, Wieling W, Axelrod FB, Benditt DG, Benarroch E, Biaggioni I, et al. Consensus statement on the definition of orthostatic hypotension, neurally mediated syncope and the postural tachycardia syndrome. Clin Auton Res. 2011;21:69–72. source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may state two separate claims as one.
- Also stated in: § Introduction · plain
In the paper
“The HR abnormality must be accompanied by chronic (>6 months) orthostatic symptoms that occur in the absence of prolonged bedrest or deconditioning, use of medications that impair autonomic regulation (vasodilators, diuretics, antidepressants, or anxiolytic agents), or other chronic debilitating disorders that might cause tachycardia (such as dehydration, anemia, or hyperthyroidism) [19].”
§ Postural Tachycardia Syndrome: Beyond Orthostatic Intolerance > Clinical Presentation of POTS > Diagnostic Criteria
What the sources say
- Not checked yetcites [19] Raj SR. Postural tachycardia syndrome (POTS). Circulation. 2013;127:2336–42. source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
In the paper
“An expert consensus statement [1] defines POTS as a HR increment ≥30 beats/min within 10 minutes of standing or head-up-tilt (HUT) which is sustained in the absence of orthostatic hypotension (a drop >20 mmHg in systolic blood pressure [BP] or >10mmHg in diastolic BP).”
- Also stated in: § Introduction · plain
“Children must meet a higher HR threshold ≥40 beats/min for a diagnosis due to their greater physiologic orthostatic tachycardia.”
§ Postural Tachycardia Syndrome: Beyond Orthostatic Intolerance > Introduction
What the sources say
- Not checked yetcites [1] Freeman R, Wieling W, Axelrod FB, Benditt DG, Benarroch E, Biaggioni I, et al. Consensus statement on the definition of orthostatic hypotension, neurally mediated syncope and the postural tachycardia syndrome. Clin Auton Res. 2011;21:69–72. source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
- Also stated in: § Introduction · plain
None of the sources cited for this claim have been checked yet.
In the paper
“This acrocyanosis in POTS is not due to increased venous compliance [22;23] but may be caused by a decrease in blood flow to the skin, possibly related to abnormal cutaneous nitric oxide activity [24].”
§ Postural Tachycardia Syndrome: Beyond Orthostatic Intolerance > Clinical Presentation of POTS > Common Clinical Features
What the sources say
- Not checked yetcites [22] Freeman R, Lirofonis V, Farquhar WB, Risk M. Limb venous compliance in patients with idiopathic orthostatic intolerance and postural tachycardia. J Appl Physiol (1985). 2002;93:636–44. source
- Not checked yetcites [23] Stewart JM. Pooling in chronic orthostatic intolerance: arterial vasoconstrictive but not venous compliance defects. Circulation. 2002;105:2274–81. source
- Not checked yetcites [24] Stewart JM, Medow MS, Minson CT, Taneja I. Cutaneous neuronal nitric oxide is specifically decreased in postural tachycardia syndrome. Am J Physiol Heart Circ Physiol. 2007;293:H2161–7. source
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Accordingly, the orthostatic tachycardia is greater with the HUT test in both patients with POTS and control subjects with prolonged tests, but the orthostatic tachycardia is comparable between HUT and active stand for the 10 minutes used for the POTS criterion [17].”
§ Postural Tachycardia Syndrome: Beyond Orthostatic Intolerance > Clinical Presentation of POTS > Diagnostic Criteria
What the sources say
- Not checked yetcites [17] Plash WB, Diedrich A, Biaggioni I, Garland EM, Paranjape SY, Black BK, et al. Diagnosing postural tachycardia syndrome: comparison of tilt testing compared with standing haemodynamics. Clin Sci (Lond). 2013;124:109–14. This study compared the heart rate (HR) increases with a head up tilt test and a stand test. Over the 10 min used for the POTS HR criterion, there was not a significant difference, but over 30 min, the HR increases were greater with the tilt test than the stand test. source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“A higher measure for sleep problems is strongly negatively correlated with the RAND-36 physical health composite score and significantly, but to a lesser degree, correlated with the mental health composite score [5].”
§ Postural Tachycardia Syndrome: Beyond Orthostatic Intolerance > Disorders Overlapping with POTS > Chronic Fatigue Syndrome (CFS)
What the sources say
- Not checked yetcites [5] Bagai K, Song Y, Ling JF, Malow B, Black BK, Biaggioni I, et al. Sleep disturbances and diminished quality of life in postural tachycardia syndrome. J Clin Sleep Med. 2011;7:204–10. source
boostedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“POTS patients describe poorer sleep quality, more daytime sleepiness, greater fatigue, and substandard quality of life compared to healthy subjects [5].”
§ Postural Tachycardia Syndrome: Beyond Orthostatic Intolerance > Disorders Overlapping with POTS > Chronic Fatigue Syndrome (CFS)
What the sources say
- Not checked yetcites [5] Bagai K, Song Y, Ling JF, Malow B, Black BK, Biaggioni I, et al. Sleep disturbances and diminished quality of life in postural tachycardia syndrome. J Clin Sleep Med. 2011;7:204–10. source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“A comprehensive neuropsychological evaluation of 28 patients in a seated position found deficits in selective attention and cognitive processing, as well as impaired executive functioning. Memory function did not differ from healthy controls [29].”
§ Postural Tachycardia Syndrome: Beyond Orthostatic Intolerance > Clinical Presentation of POTS > Psychological Profile in POTS
What the sources say
- Not checked yetcites [29] Arnold AC, Haman K, Garland EM, Raj V, Dupont WD, Biaggioni I, et al. Cognitive dysfunction in postural tachycardia syndrome. Clin Sci (Lond). 2015;128:39–45. This recent study formally looked at neurocognitive testing in POTS patients and healthy control subjects. Selective attention, cognitive processing speed, and measures of executive function are reduced in POTS. Follow-up studies looking at therapeutic approaches are underway. source
plainn = 28- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Autonomic testing indicated a similar autonomic profile but higher sympathetic tone in patients with CFS.”
§ Postural Tachycardia Syndrome: Beyond Orthostatic Intolerance > Disorders Overlapping with POTS > Chronic Fatigue Syndrome (CFS)
What the sources say
- Not checked yetcites [33] Okamoto LE, Raj SR, Peltier A, Gamboa A, Shibao C, Diedrich A, et al. Neurohumoral and haemodynamic profile in postural tachycardia and chronic fatigue syndromes. Clin Sci (Lond). 2012;122:183–92. source
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“A significant minority of POTS patients are diagnosed following a virus-like syndrome. This suggests an autoimmune cause for POTS in some patients.”
§ Postural Tachycardia Syndrome: Beyond Orthostatic Intolerance > Pathophysiology of POTS > Autoimmune/Autoantibodies
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Although it may not be clear if deconditioning is a primary problem or secondary to POTS, many patients with POTS do have cardiovascular deconditioning and do benefit from a program of aerobic exercise and resistance training [13].”
§ Postural Tachycardia Syndrome: Beyond Orthostatic Intolerance > Pathophysiology of POTS > Physical deconditioning
What the sources say
- Not checked yetcites [13] Fu Q, Vangundy TB, Galbreath MM, Shibata S, Jain M, Hastings JL, et al. Cardiac origins of the postural orthostatic tachycardia syndrome. J Am Coll Cardiol. 2010;55:2858–68. source
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“When measured during upright posture, norepinephrine is elevated in many patients with POTS [>3.55 nmol/L (600 pg/mL) and sometimes >5.91 nmol/L (1000 pg/mL)], consistent with the sympathetic neuronal activation elicited by standing in these patients [19].”
§ Postural Tachycardia Syndrome: Beyond Orthostatic Intolerance > Pathophysiology of POTS > Central Hyperadrenergic POTS
What the sources say
- Not checked yetcites [19] Raj SR. Postural tachycardia syndrome (POTS). Circulation. 2013;127:2336–42. source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“These paradoxical findings suggest that POTS patients might have decreased angiotensin II metabolism and that dysregulation by the renin-angiotensin-aldosterone system might contribute to hypovolemia in POTS [50;51].”
§ Postural Tachycardia Syndrome: Beyond Orthostatic Intolerance > Pathophysiology of POTS > Hypovolemia and the Renin-Angiotensin-Aldosterone System in POTS
What the sources say
- Not checked yetcites [50] Mustafa HI, Garland EM, Biaggioni I, Black BK, Dupont WD, Robertson D, et al. Abnormalities of angiotensin regulation in postural tachycardia syndrome. Heart Rhythm. 2011;8:422–8. source
- Not checked yetcites [51] Stewart JM, Glover JL, Medow MS. Increased plasma angiotensin II in postural tachycardia syndrome (POTS) is related to reduced blood flow and blood volume. Clin Sci (Lond). 2006;110:255–63. source
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Some POTS patients present with severe flushing in addition to their tachycardia and have an associated mast cell activation disorder.”
§ Postural Tachycardia Syndrome: Beyond Orthostatic Intolerance > Pathophysiology of POTS > Mast Cell Activation
What the sources say
- Not checked yetcites [56] Shibao C, Arzubiaga C, Roberts LJ, Raj S, Black B, Harris P, et al. Hyperadrenergic postural tachycardia syndrome in mast cell activation disorders. Hypertension. 2005;45:385–90. source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Patients with POTS have a high prevalence of chronic fatigue (48-77%) and of CFS (17-23%) [33;8].”
§ Postural Tachycardia Syndrome: Beyond Orthostatic Intolerance > Disorders Overlapping with POTS > Chronic Fatigue Syndrome (CFS)
What the sources say
- Not checked yetcites [33] Okamoto LE, Raj SR, Peltier A, Gamboa A, Shibao C, Diedrich A, et al. Neurohumoral and haemodynamic profile in postural tachycardia and chronic fatigue syndromes. Clin Sci (Lond). 2012;122:183–92. source
- Not checked yetcites [8] Sheldon RS, Grubb BP, Olshansky B, Shen WK, Calkins H, Brignole M, et al. 2015 heart rhythm society expert consensus statement on the diagnosis and treatment of postural tachycardia syndrome, inappropriate sinus tachycardia, and vasovagal syncope. Heart Rhythm. 2015;12:e41–63. The Heart Rhythm Society has recently published its first consensus statement on the diagnosis and treatment of postural tachycardia syndrome (POTS) and other disorders. While not comprehensive, it provides an excellent starting point for a clinician wanting to learn about the management of POTS. source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“When patients were grouped according to whether or not they met the criteria for CFS [33], fatigue symptoms, orthostatic changes in HR and BP after 10 minutes, supine and upright plasma norepinephrine, and plasma volume were similar for the two groups.”
§ Postural Tachycardia Syndrome: Beyond Orthostatic Intolerance > Disorders Overlapping with POTS > Chronic Fatigue Syndrome (CFS)
What the sources say
- Not checked yetcites [33] Okamoto LE, Raj SR, Peltier A, Gamboa A, Shibao C, Diedrich A, et al. Neurohumoral and haemodynamic profile in postural tachycardia and chronic fatigue syndromes. Clin Sci (Lond). 2012;122:183–92. source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“A spectral analysis index of sympathetic function and plasma norepinephrine are sometimes higher at supine rest and increase more with HUT in POTS [53;52].”
§ Postural Tachycardia Syndrome: Beyond Orthostatic Intolerance > Pathophysiology of POTS > Central Hyperadrenergic POTS
What the sources say
- Not checked yetcites [53] Garland EM, Raj SR, Black BK, Harris PA, Robertson D. The hemodynamic and neurohumoral phenotype of postural tachycardia syndrome. Neurology. 2007;69:790–8. source
- Not checked yetcites [52] Furlan R, Jacob G, Snell M, Robertson D, Porta A, Harris P, et al. Chronic orthostatic intolerance: a disorder with discordant cardiac and vascular sympathetic control. Circulation. 1998;98:2154–9. source
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Sympathetic denervation obstructs compensatory vascular constriction during upright posture, allowing blood to pool in the splanchnic vasculature and lower extremities [7;43;8]. The resulting decrease in venous return leads to the sympathetic activation and tachycardia of POTS.”
§ Postural Tachycardia Syndrome: Beyond Orthostatic Intolerance > Pathophysiology of POTS > Neuropathic POTS
What the sources say
- Not checked yetcites [7] Grubb BP. Postural tachycardia syndrome. Circulation. 2008;117:2814–7. source
- Not checked yetcites [43] Stewart JM, Medow MS, Glover JL, Montgomery LD. Persistent splanchnic hyperemia during upright tilt in postural tachycardia syndrome. Am J Physiol Heart Circ Physiol. 2006;290:H665–73. source
- Not checked yetcites [8] Sheldon RS, Grubb BP, Olshansky B, Shen WK, Calkins H, Brignole M, et al. 2015 heart rhythm society expert consensus statement on the diagnosis and treatment of postural tachycardia syndrome, inappropriate sinus tachycardia, and vasovagal syncope. Heart Rhythm. 2015;12:e41–63. The Heart Rhythm Society has recently published its first consensus statement on the diagnosis and treatment of postural tachycardia syndrome (POTS) and other disorders. While not comprehensive, it provides an excellent starting point for a clinician wanting to learn about the management of POTS. source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Wallman et al. ascertained the prevalence of EDS in their POTS population: 18% of POTS patients met criteria for EDS, compared to a 0.02% prevalence in the general population and 4% prevalence in their autonomic clinic patients without POTS [34].”
§ Postural Tachycardia Syndrome: Beyond Orthostatic Intolerance > Disorders Overlapping with POTS > Ehlers-Danlos Syndrome (EDS)
What the sources say
- Not checked yetcites [34] Wallman D, Weinberg J, Hohler AD. Ehlers-Danlos syndrome and postural tachycardia syndrome: a relationship study. J Neurol Sci. 2014;340:99–102. This study assessed the incidence of Ehlers-Danlos syndrome in a cohort of POTS patients and found the incidence of EDS in POTS to be 18%, vs. 4% in non-POTS patients from an autonomic clinic, and an estimated prevalence of 0.02% in the general population. source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Central sympatholytics (e.g. clonidine and methyldopa) can also be used to decrease sympathetic tone in patients with prominent hyperadrenergic features, but might produce drowsiness and worsening of the mental clouding [19] (HRS Class IIb) [8].”
§ Postural Tachycardia Syndrome: Beyond Orthostatic Intolerance > Treatment of POTS (Table 2) > Pharmacological Treatment of POTS
What the sources say
- Not checked yetcites [19] Raj SR. Postural tachycardia syndrome (POTS). Circulation. 2013;127:2336–42. source
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Symptoms can be exacerbated by simple activities of daily life like standing still, exercise, food or alcohol ingestion, or heat exposure [26].”
§ Postural Tachycardia Syndrome: Beyond Orthostatic Intolerance > Clinical Presentation of POTS > Common Clinical Features
What the sources say
- Not checked yetcites [26] Thieben MJ, Sandroni P, Sletten DM, Benrud-Larson LM, Fealey RD, Vernino S, et al. Postural orthostatic tachycardia syndrome: the Mayo Clinic experience. Mayo Clin Proc. 2007;82:308–13. source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“The heart rate abnormality and orthostatic symptoms should not be caused by medications that impair autonomic regulation or by debilitating disorders that can cause tachycardia.”
§ Postural Tachycardia Syndrome: Beyond Orthostatic Intolerance > Abstract
What the sources say
- Not checked yetcites [19] Raj SR. Postural tachycardia syndrome (POTS). Circulation. 2013;127:2336–42. source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Central sympatholytics (e.g. clonidine and methyldopa) can also be used to decrease sympathetic tone in patients with prominent hyperadrenergic features, but might produce drowsiness and worsening of the mental clouding [19] (HRS Class IIb) [8].”
§ Postural Tachycardia Syndrome: Beyond Orthostatic Intolerance > Treatment of POTS (Table 2) > Pharmacological Treatment of POTS
What the sources say
- Not checked yetcites [8] Sheldon RS, Grubb BP, Olshansky B, Shen WK, Calkins H, Brignole M, et al. 2015 heart rhythm society expert consensus statement on the diagnosis and treatment of postural tachycardia syndrome, inappropriate sinus tachycardia, and vasovagal syncope. Heart Rhythm. 2015;12:e41–63. The Heart Rhythm Society has recently published its first consensus statement on the diagnosis and treatment of postural tachycardia syndrome (POTS) and other disorders. While not comprehensive, it provides an excellent starting point for a clinician wanting to learn about the management of POTS. source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“More generalized complaints in patients with POTS include hypermobile joints, exercise intolerance, migraine headaches, sleep disturbances, and fatigue [19].”
§ Postural Tachycardia Syndrome: Beyond Orthostatic Intolerance > Clinical Presentation of POTS > Common Clinical Features
What the sources say
- Not checked yetcites [19] Raj SR. Postural tachycardia syndrome (POTS). Circulation. 2013;127:2336–42. source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Improvement in symptoms and orthostatic tachycardia can be associated with scalp tingling and goosebumps [58], and midodrine can cause urinary retention [67].”
§ Postural Tachycardia Syndrome: Beyond Orthostatic Intolerance > Treatment of POTS (Table 2) > Pharmacological Treatment of POTS
What the sources say
- Not checked yetcites [58] Jacob G, Shannon JR, Black B, Biaggioni I, Mosqueda-Garcia R, Robertson RM, et al. Effects of volume loading and pressor agents in idiopathic orthostatic tachycardia. Circulation. 1997;96:575–80. source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Abdominal compression with elastic waist-high support hose and abdominal binders can help decrease splanchnic-mesenteric venous pooling during standing [43]. The increase in venous return and stroke volume can decrease the orthostatic tachycardia [19;59].”
§ Postural Tachycardia Syndrome: Beyond Orthostatic Intolerance > Treatment of POTS (Table 2) > Non-Pharmacological Treatment of POTS
What the sources say
- Not checked yetcites [43] Stewart JM, Medow MS, Glover JL, Montgomery LD. Persistent splanchnic hyperemia during upright tilt in postural tachycardia syndrome. Am J Physiol Heart Circ Physiol. 2006;290:H665–73. source
- Not checked yetcites [19] Raj SR. Postural tachycardia syndrome (POTS). Circulation. 2013;127:2336–42. source
- Not checked yetcites [59] Smit AA, Wieling W, Fujimura J, Denq JC, Opfer-Gehrking TL, Akarriou M, et al. Use of lower abdominal compression to combat orthostatic hypotension in patients with autonomic dysfunction. Clin Auton Res. 2004;14:167–75.
plainconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Improvement is related to an increase in the size of the heart and increased blood volume [13]. The improved stroke volume decreases tachycardia.”
§ Postural Tachycardia Syndrome: Beyond Orthostatic Intolerance > Treatment of POTS (Table 2) > Non-Pharmacological Treatment of POTS
What the sources say
- Not checked yetcites [13] Fu Q, Vangundy TB, Galbreath MM, Shibata S, Jain M, Hastings JL, et al. Cardiac origins of the postural orthostatic tachycardia syndrome. J Am Coll Cardiol. 2010;55:2858–68. source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Increasing parasympathetic tone with pyridostigmine can also curtail HR in POTS [65] (HRS Class IIb) [8].”
§ Postural Tachycardia Syndrome: Beyond Orthostatic Intolerance > Treatment of POTS (Table 2) > Pharmacological Treatment of POTS
What the sources say
- Not checked yetcites [8] Sheldon RS, Grubb BP, Olshansky B, Shen WK, Calkins H, Brignole M, et al. 2015 heart rhythm society expert consensus statement on the diagnosis and treatment of postural tachycardia syndrome, inappropriate sinus tachycardia, and vasovagal syncope. Heart Rhythm. 2015;12:e41–63. The Heart Rhythm Society has recently published its first consensus statement on the diagnosis and treatment of postural tachycardia syndrome (POTS) and other disorders. While not comprehensive, it provides an excellent starting point for a clinician wanting to learn about the management of POTS. source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Intravenous saline (1-2L) can quickly expand blood volume and lessen tachycardia in POTS patients [58].”
§ Postural Tachycardia Syndrome: Beyond Orthostatic Intolerance > Treatment of POTS (Table 2) > Non-Pharmacological Treatment of POTS
What the sources say
- Not checked yetcites [58] Jacob G, Shannon JR, Black B, Biaggioni I, Mosqueda-Garcia R, Robertson RM, et al. Effects of volume loading and pressor agents in idiopathic orthostatic tachycardia. Circulation. 1997;96:575–80. source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“The natural history of POTS is not clear, but it does not appear to increase the risk of mortality [8].”
§ Postural Tachycardia Syndrome: Beyond Orthostatic Intolerance > Introduction
What the sources say
- Not checked yetcites [8] Sheldon RS, Grubb BP, Olshansky B, Shen WK, Calkins H, Brignole M, et al. 2015 heart rhythm society expert consensus statement on the diagnosis and treatment of postural tachycardia syndrome, inappropriate sinus tachycardia, and vasovagal syncope. Heart Rhythm. 2015;12:e41–63. The Heart Rhythm Society has recently published its first consensus statement on the diagnosis and treatment of postural tachycardia syndrome (POTS) and other disorders. While not comprehensive, it provides an excellent starting point for a clinician wanting to learn about the management of POTS. source
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“These patients may have orthostatic hypertension (increase in systolic blood pressure >10 mmHg on standing) and complain of tremor, anxiety and cold, sweaty extremities [7;25].”
§ Postural Tachycardia Syndrome: Beyond Orthostatic Intolerance > Pathophysiology of POTS > Central Hyperadrenergic POTS
What the sources say
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“POTS can be treated with a combination of non-pharmacological approaches, a structured exercise training program, and often some pharmacological support.”
§ Postural Tachycardia Syndrome: Beyond Orthostatic Intolerance > Abstract
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper may give no reason why it holds.
In the paper
“The non-selective β-AR antagonist propranolol acutely restrains orthostatic tachycardia and symptoms at doses that appear to be low enough (10-20 mg) to avoid the side effect of significant fatigue [64].”
§ Postural Tachycardia Syndrome: Beyond Orthostatic Intolerance > Treatment of POTS (Table 2) > Pharmacological Treatment of POTS
What the sources say
- Not checked yetcites [64] Raj SR, Black BK, Biaggioni I, Paranjape SY, Ramirez M, Dupont WD, et al. Propranolol decreases tachycardia and improves symptoms in the postural tachycardia syndrome: less is more. Circulation. 2009;120:725–34. source
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Excessive tachycardia in POTS occurs during exercise as well as during standing [60;61], and patients experience significant exercise intolerance [9;19].”
§ Postural Tachycardia Syndrome: Beyond Orthostatic Intolerance > Treatment of POTS (Table 2) > Non-Pharmacological Treatment of POTS
What the sources say
- Not checked yetcites [60] Masuki S, Eisenach JH, Schrage WG, Dietz NM, Johnson CP, Wilkins BW, et al. Arterial baroreflex control of heart rate during exercise in postural tachycardia syndrome. J Appl Physiol (1985). 2007;103:1136–42. source
- Not checked yetcites [61] Masuki S, Eisenach JH, Schrage WG, Johnson CP, Dietz NM, Wilkins BW, et al. Reduced stroke volume during exercise in postural tachycardia syndrome. J Appl Physiol (1985). 2007;103:1128–35. source
- Not checked yetcites [9] Medow MS, Stewart JM. The postural tachycardia syndrome. Cardiol Rev. 2007;15:67–75. source
- Not checked yetcites [19] Raj SR. Postural tachycardia syndrome (POTS). Circulation. 2013;127:2336–42. source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Autonomic problems in POTS might include gastrointestinal complaints, such as abdominal pain, nausea and irritable bowel syndrome, as well as bladder symptoms and abnormal sudomotor regulation [19;26].”
§ Postural Tachycardia Syndrome: Beyond Orthostatic Intolerance > Clinical Presentation of POTS > Common Clinical Features
What the sources say
- Not checked yetcites [19] Raj SR. Postural tachycardia syndrome (POTS). Circulation. 2013;127:2336–42. source
- Not checked yetcites [26] Thieben MJ, Sandroni P, Sletten DM, Benrud-Larson LM, Fealey RD, Vernino S, et al. Postural orthostatic tachycardia syndrome: the Mayo Clinic experience. Mayo Clin Proc. 2007;82:308–13. source
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Improvement in symptoms and orthostatic tachycardia can be associated with scalp tingling and goosebumps [58], and midodrine can cause urinary retention [67].”
§ Postural Tachycardia Syndrome: Beyond Orthostatic Intolerance > Treatment of POTS (Table 2) > Pharmacological Treatment of POTS
What the sources say
- Not checked yetcites [67] Benarroch EE. Postural tachycardia syndrome: a heterogeneous and multifactorial disorder. Mayo Clin Proc. 2012;87:1214–25. source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Improvement in symptoms and orthostatic tachycardia can be associated with scalp tingling and goosebumps [58], and midodrine can cause urinary retention [67].”
§ Postural Tachycardia Syndrome: Beyond Orthostatic Intolerance > Treatment of POTS (Table 2) > Pharmacological Treatment of POTS
What the sources say
- Not checked yetcites [58] Jacob G, Shannon JR, Black B, Biaggioni I, Mosqueda-Garcia R, Robertson RM, et al. Effects of volume loading and pressor agents in idiopathic orthostatic tachycardia. Circulation. 1997;96:575–80. source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Propranolol is a HRS Class IIb recommendation [8].”
§ Postural Tachycardia Syndrome: Beyond Orthostatic Intolerance > Treatment of POTS (Table 2) > Pharmacological Treatment of POTS
What the sources say
- Not checked yetcites [8] Sheldon RS, Grubb BP, Olshansky B, Shen WK, Calkins H, Brignole M, et al. 2015 heart rhythm society expert consensus statement on the diagnosis and treatment of postural tachycardia syndrome, inappropriate sinus tachycardia, and vasovagal syncope. Heart Rhythm. 2015;12:e41–63. The Heart Rhythm Society has recently published its first consensus statement on the diagnosis and treatment of postural tachycardia syndrome (POTS) and other disorders. While not comprehensive, it provides an excellent starting point for a clinician wanting to learn about the management of POTS. source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“Although DDAVP reduces tachycardia and symptoms [72;71], it can lead to hyponatremia.”
§ Postural Tachycardia Syndrome: Beyond Orthostatic Intolerance > Treatment of POTS (Table 2) > Pharmacological Treatment of POTS
What the sources say
- Not checked yetcites [72] Coffin ST, Black BK, Biaggioni I, Paranjape SY, Orozco C, Black PW, et al. Desmopressin acutely decreases tachycardia and improves symptoms in the postural tachycardia syndrome. Heart Rhythm. 2012;9:1484–90. source
- Not checked yetcites [71] Nwazue VC, Raj SR. Confounders of vasovagal syncope: postural tachycardia syndrome. Cardiol Clin. 2013;31:101–9. source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Erythropoietin increases red cell mass and may also stimulate vasoconstriction [7].”
§ Postural Tachycardia Syndrome: Beyond Orthostatic Intolerance > Treatment of POTS (Table 2) > Pharmacological Treatment of POTS
What the sources say
- Not checked yetcites [7] Grubb BP. Postural tachycardia syndrome. Circulation. 2008;117:2814–7. source
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“This, combined with its high cost and the need for injection, makes it a less attractive option [11].”
§ Postural Tachycardia Syndrome: Beyond Orthostatic Intolerance > Treatment of POTS (Table 2) > Pharmacological Treatment of POTS
What the sources say
- Not checked yetcites [11] Johnson JN, Mack KJ, Kuntz NL, Brands CK, Porter CJ, Fischer PR. Postural orthostatic tachycardia syndrome: a clinical review. Pediatr Neurol. 2010;42:77–85. source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“This effect during standing helps to maintain venous return in POTS and inhibits the compensatory increase in HR following acute and chronic administration [68;69].”
§ Postural Tachycardia Syndrome: Beyond Orthostatic Intolerance > Treatment of POTS (Table 2) > Pharmacological Treatment of POTS
What the sources say
- Not checked yetcites [68] Hoeldtke RD, Bryner KD, Hoeldtke ME, Hobbs G. Treatment of postural tachycardia syndrome: a comparison of octreotide and midodrine. Clin Auton Res. 2006;16:390–5. source
- Not checked yetcites [69] Kanjwal K, Saeed B, Karabin B, Kanjwal Y, Grubb BP. Use of octreotide in the treatment of refractory orthostatic intolerance. Am J Ther. 2012;19:7–10. source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Fludrocortisone is a HRS Class IIb recommendation [8].”
§ Postural Tachycardia Syndrome: Beyond Orthostatic Intolerance > Treatment of POTS (Table 2) > Pharmacological Treatment of POTS
What the sources say
- Not checked yetcites [8] Sheldon RS, Grubb BP, Olshansky B, Shen WK, Calkins H, Brignole M, et al. 2015 heart rhythm society expert consensus statement on the diagnosis and treatment of postural tachycardia syndrome, inappropriate sinus tachycardia, and vasovagal syncope. Heart Rhythm. 2015;12:e41–63. The Heart Rhythm Society has recently published its first consensus statement on the diagnosis and treatment of postural tachycardia syndrome (POTS) and other disorders. While not comprehensive, it provides an excellent starting point for a clinician wanting to learn about the management of POTS. source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“A number of nonspecific symptoms that are both associated with and independent of upright posture create a clinical phenotype that overlaps with other disorders like CFS.”
§ Postural Tachycardia Syndrome: Beyond Orthostatic Intolerance > Conclusions
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“POTS is not a single disease.”
§ Postural Tachycardia Syndrome: Beyond Orthostatic Intolerance > Conclusions
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
In the paper
“Midodrine is a HRS Class IIb recommendation in POTS [8].”
§ Postural Tachycardia Syndrome: Beyond Orthostatic Intolerance > Treatment of POTS (Table 2) > Pharmacological Treatment of POTS
What the sources say
- Not checked yetcites [8] Sheldon RS, Grubb BP, Olshansky B, Shen WK, Calkins H, Brignole M, et al. 2015 heart rhythm society expert consensus statement on the diagnosis and treatment of postural tachycardia syndrome, inappropriate sinus tachycardia, and vasovagal syncope. Heart Rhythm. 2015;12:e41–63. The Heart Rhythm Society has recently published its first consensus statement on the diagnosis and treatment of postural tachycardia syndrome (POTS) and other disorders. While not comprehensive, it provides an excellent starting point for a clinician wanting to learn about the management of POTS. source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“POTS can be treated with a combination of non-pharmacological approaches, a structured exercise training program, and often some pharmacological support.”
§ Postural Tachycardia Syndrome: Beyond Orthostatic Intolerance > Conclusions
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“However, octreotide is only available in an injectable form, and this likely limits its use and patient acceptability.”
§ Postural Tachycardia Syndrome: Beyond Orthostatic Intolerance > Treatment of POTS (Table 2) > Pharmacological Treatment of POTS
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
In the paper
“The HRS cautions against their use in POTS (HRS Class III) [8].”
§ Postural Tachycardia Syndrome: Beyond Orthostatic Intolerance > Treatment of POTS (Table 2) > Pharmacological Treatment of POTS
What the sources say
- Not checked yetcites [8] Sheldon RS, Grubb BP, Olshansky B, Shen WK, Calkins H, Brignole M, et al. 2015 heart rhythm society expert consensus statement on the diagnosis and treatment of postural tachycardia syndrome, inappropriate sinus tachycardia, and vasovagal syncope. Heart Rhythm. 2015;12:e41–63. The Heart Rhythm Society has recently published its first consensus statement on the diagnosis and treatment of postural tachycardia syndrome (POTS) and other disorders. While not comprehensive, it provides an excellent starting point for a clinician wanting to learn about the management of POTS. source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“Fludrocortisone also stimulates potassium excretion, making it necessary to watch for hypokalemia, and it can also worsen migraine headaches [71;19].”
§ Postural Tachycardia Syndrome: Beyond Orthostatic Intolerance > Treatment of POTS (Table 2) > Pharmacological Treatment of POTS
What the sources say
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper relies on this without support.
No drugs are approved by the US Food and Drug Administration for the treatment of POTS.
“The US Food and Drug Administration has not approved any drugs for the treatment of POTS.”
The paper relies on this without support.
Midodrine increases peripheral resistance in POTS by stimulating vasoconstriction.
“Midodrine, a pro-drug of an α1-AR agonist, can increase peripheral resistance in POTS by stimulating vasoconstriction.”
The paper relies on this without support.
Octreotide acts as a vasoconstrictor, primarily in the splanchnic circulation.
“The somatostatin analog octreotide is a vasoconstrictor that mainly affects the splanchnic circulation.”
The paper relies on this without support.
Ivabradine slows heart rate by inhibiting the funny channel current in the sinoatrial node without affecting blood pressure.
“Ivabradine is a cardioselective agent that slows HR via inhibition of the funny channel current (If) in the cardiac sinoatrial node but does not affect BP.”
The paper relies on this without support.
Ivabradine is approved for heart failure in the US and Europe and for angina in Europe.
“Ivabradine is approved for the treatment of heart failure (US & Europe) and angina (Europe).”
The paper relies on this without support.
Fludrocortisone acts on the mineralocorticoid receptor and quickly boosts sodium reabsorption in the kidney's distal tubules.
“Fludrocortisone is a synthetic corticosteroid that preferentially binds to the mineralocorticoid receptor and acutely increases sodium reabsorption in the distal tubules of the kidney.”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In the citing paper
“POTS may simply be a final common pathway for several interrelated pathophysiologic mechanisms (50).”
From Postural orthostatic tachycardia syndrome: mechanisms and new therapies (2020) · cites this paper as [50]
In the citing paper
“Elevations in plasma norepinephrine suggest an increase in sympathoneural tone (10).”
From Effect of High Dietary Sodium Intake in Patients With Postural Tachycardia Syndrome (2021) · cites this paper as [10]
In the citing paper
“A high sodium diet (10–12 g NaCl/day equivalent to 170–205 mEq or mmoles sodium/day) and increased water intake (2–3L/day) are often prescribed to expand plasma volume in patients (3, 4, 10).”
From Effect of High Dietary Sodium Intake in Patients With Postural Tachycardia Syndrome (2021) · cites this paper as [10]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
§ Postural Tachycardia Syndrome: Beyond Orthostatic Intolerance > Introduction
“Patients with POTS experience cardiac and non-cardiac presyncopal symptoms chronically (≥6 months).”
§ Postural Tachycardia Syndrome: Beyond Orthostatic Intolerance > Clinical Presentation of POTS > Diagnostic Criteria
“The HR abnormality must be accompanied by chronic (>6 months) orthostatic symptoms”
Citations
Cites
Goodman & Gilman's The Pharmacological Basis of Therapeutics
Brunton, L. L. (1985) · Cited by 7,321
Freeman, R., Wieling, W., Axelrod, F. B., Benditt, D. G., Benarroch, E., Biaggioni, I., Cheshire, W. P., Chelimsky, T., Cortelli, P., Gibbons, C. H., et al. (2011) · Clinical Autonomic Research · doi:10.1007/s10286-011-0119-5 · Cited by 1,697 · cited 6×
“• In the absence of other disorders or medications that are known to predispose to orthostatic tachycardia 60 Page 2 of 11 Curr Neurol Neurosci Rep (2015) 15: 60”
BackgroundMethodResultInfluentialSelf-citationFreeman, R., Wieling, W., Axelrod, F. B., Benditt, D. G., Benarroch, E., Biaggioni, I., Cheshire, W. P., Chelimsky, T., Cortelli, P., Gibbons, C. H., et al. (2011) · Autonomic Neuroscience · doi:10.1016/j.autneu.2011.02.004 · Cited by 1,243
Self-citationSheldon, R. S., Grubb, B. P., Olshansky, B., Shen, W.-K., Calkins, H., Brignole, M., Raj, S. R., Krahn, A. D., Morillo, C. A., Stewart, J. M., et al. (2015) · Heart Rhythm · doi:10.1016/j.hrthm.2015.03.029 · Cited by 1,013
Self-citationRossi, P., Andriesse, G. I., Oey, P. L., Wieneke, G. H., Roelofs, J. M. M., & Akkermans, L. M. A. (1998) · Journal of the Neurological Sciences · doi:10.1016/s0022-510x(98)00276-7 · Cited by 767
Orthostatic Intolerance and Tachycardia Associated with Norepinephrine-Transporter Deficiency
Shannon, J. R., Flattem, N. L., Jordan, J., Jacob, G., Black, B. K., Biaggioni, I., Blakely, R. D., & Robertson, D. (2000) · New England Journal of Medicine · doi:10.1056/nejm200002243420803 · Cited by 594
Idiopathic postural orthostatic tachycardia syndrome: An attenuated form of acute pandysautonomia?
Schondorf, R., & Low, P. A. (1993) · Neurology · doi:10.1212/wnl.43.1_part_1.132 · Cited by 548
Postural orthostatic tachycardia syndrome: the Mayo clinic experience
Thieben, M. J., Sandroni, P., Sletten, D. M., Benrud-Larson, L. M., Fealey, R. D., Vernino, S., Low, P. A., Lennon, V. A., & Shen, W.-K. (2007) · Mayo Clinic Proceedings · doi:10.1016/s0025-6196(11)61027-6 · Cited by 516
The neuropathic postural tachycardia syndrome
Jacob, G., Costa, F., Shannon, J. R., Robertson, R. M., Wathen, M., Stein, M., Biaggioni, I., Ertl, A., Black, B., & Robertson, D. (2000) · New England Journal of Medicine · doi:10.1056/nejm200010053431404 · Cited by 398
Dysautonomia in the joint hypermobility syndrome
Gazit, Y., Nahir, A. M., Grahame, R., & Jacob, G. (2003) · The American Journal of Medicine · doi:10.1016/s0002-9343(03)00235-3 · Cited by 390
Cited by
Sorted by citations
Postural orthostatic tachycardia syndrome: clinical presentation, aetiology and management
Fedorowski, A. (2019) · Journal of Internal Medicine · doi:10.1111/joim.12852 · Cited by 352
Shaw, B. H., Stiles, L. E., Bourne, K., Green, E. A., Shibao, C. A., Okamoto, L. E., Garland, E. M., Gamboa, A., Diedrich, A., Raj, V., et al. (2019) · Journal of Internal Medicine · doi:10.1111/joim.12895 · Cited by 326
Self-citationPostural Orthostatic Tachycardia Syndrome
Bryarly, M., Phillips, L. T., Fu, Q., Vernino, S., & Levine, B. D. (2019) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2018.11.059 · Cited by 245
Pediatric Disorders of Orthostatic Intolerance
Stewart, J. M., Boris, J. R., Chelimsky, G., Fischer, P. R., Fortunato, J. E., Grubb, B. P., Heyer, G. L., Jarjour, I. T., Medow, M. S., Numan, M. T., et al. (2018) · Pediatrics · doi:10.1542/peds.2017-1673 · Cited by 222
Postural tachycardia syndrome – Diagnosis, physiology, and prognosis
Arnold, A. C., Ng, J., & Raj, S. R. (2018) · Autonomic Neuroscience · doi:10.1016/j.autneu.2018.02.005 · Cited by 186
Self-citation
Metadata
- Authors
- Garland, E. M., Celedonio, J. E., & Raj, S. R.
- Affiliations
- Vanderbilt University (US)
- University of Calgary (CA)
- Corresponding author
- Garland, Emily M.
- Venue
- Current Neurology and Neuroscience Reports
- Published
- 2015-07-22
- Volume
- 15
- Issue
- 9
- Pages
- 60-60
- ISSN
- 1528-4042 (ISSN-L)
- 1534-6293
- PMC
- PMC4664448
- OpenAlex
- W1854421037
- Cited by
- 160
- References
- 78
- Citations by year
- 2026: 5 · 2025: 12 · 2024: 13 · 2023: 7 · 2022: 25 · 2021: 20 · 2020: 21 · 2019: 16 · 2018: 19 · 2017: 15 · 2016: 5
- FWCI
- 2.49
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Current Neurology and Neuroscience Reports (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (UL1TR000445, TR000445)
- National Heart, Lung, and Blood Institute (R01HL071784, P01HL056693, R01HL102387, P01 HL-56693)
- National Institute of Neurological Disorders and Stroke (U54NS065736)
- National Center for Advancing Translational Sciences
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Syncope and Autonomic Disorders
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
- Health Sciences › Medicine › Clinical Neurology › Long-Term Effects of COVID-19
- Keywords
- postural orthostatic tachycardia syndrome, orthostatic intolerance, orthostatic tachycardia, autonomic dysfunction, autonomic neuropathy, hypovolemia, sympathetic hyperactivity, mast cell activation, deconditioning, autoantibodies, chronic fatigue syndrome, Ehlers-Danlos syndrome, vasovagal syncope, inappropriate sinus tachycardia, exercise training, pharmacotherapy
- MeSH terms
- Chronic Disease, Heart Rate, Humans, Mast Cells, Posture, Orthostatic Intolerance, Postural Orthostatic Tachycardia Syndrome
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
A language model drew the claims from the paper on 2026-10-06, under version 3 of the claim definition (model deepseek-v4.1-flash, prompt extract-v3).
A second model labelled each claim on 2026-10-06 (model jev-1.13-20260917, definition revision gold-guideline-v0.2).
Cited sources are checked with a language model’s help (gpt-6-sol).
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
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