# Patient Characteristics of a Telemedicine Clinic for Pediatric and Young Adult Postural Orthostatic Tachycardia Syndrome

## TL;DR

This study examines the characteristics of young POTS patients through a telemedicine clinic, revealing common comorbid conditions and symptoms.

## Contribution

The study identifies previously underreported symptoms and conditions in pediatric and young adult POTS patients using a telemedicine approach.

## Key findings

- 70% of patients showed suspected mast cell activation syndrome.
- 78.3% of patients had joint hypermobility, more common in females.
- Headaches and head trauma were frequently reported, with sex-based differences observed.

## Abstract

Background: Postural orthostatic tachycardia syndrome (POTS) includes multiple symptoms and comorbid conditions. Assessment for less recognized symptoms and conditions was performed through a telemedicine-only clinic for adolescent and young adult patients with POTS. Methods: A retrospective review of records was performed for information obtained during clinical care. Patients up through the age of 23 years were evaluated, either diagnosing or confirming a diagnosis of POTS, and identifying other symptoms and diagnoses. These data were evaluated for differences, including by sex and presence or absence of joint hypermobility. Results: In total, 277 patients met the inclusion criteria. The median age was 16.8 years (IQR 15.2–19.1); 88.1% were female. Suspected mast cell activation syndrome occurred in 70% of patients. Joint hypermobility was found in 78.3% of patients; female patients were more affected (80.3% versus 63.6%); 57.0% had both suspected MCAS and joint hypermobility. Migraine was seen in 51.6% of patients; 57.4% had tension-type headache. Females appeared more likely to have tension headache or both types of headache together, while males seemed more likely to have migraine. Joint hypermobility did not influence headache presence or absence. A history of head trauma/concussion was reported in 39.7% of patients, with 14.4% having vestibular symptoms and 4% having convergence disorder. Without head trauma/concussion, 23.8% of patients reported vestibular symptoms, convergence disorder, or both. Conclusions: We report previously unrecognized or poorly described symptoms and conditions accompanying POTS. Recognition of these symptoms and conditions in patients with POTS can allow for more complete evaluation and management of debilitating factors and may give insights into underlying pathophysiologies leading to POTS.