Key distinguishing features among orthostatic intolerance syndromes

Condition	Autonomic changes		Orthostatic symptoms^Δ
Condition	BP*	HR^¶	Orthostatic symptoms^Δ
POTS	↔	↑	+
Orthostatic hypotension	↓	↑	+
Reflex syncope	↓↓	↓	+
Chronic isolated orthostatic intolerance	↔	↔	+
Benign tachycardia	↔	↑	–

BP: blood pressure; HR: heart rate; POTS: postural tachycardia syndrome.

* Drop in BP defined by decrease in systolic or diastolic BP at least 20 or 10 mmHg, respectively.

¶ Elevation defined by HR elevation exceeding 30 beats/minute (40 beats/minute in patients under 20 years of age) above a resting baseline.

Δ Symptoms brought on by standing and relieved by sitting down. Common symptoms include lightheadedness, palpitations, weakness, and difficulty concentrating.

Courtesy of William P Cheshire, MD.

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Key distinguishing features among orthostatic intolerance syndromes