Some people with postural orthostatic tachycardia syndrome (POTS) may have a suspicion about their diagnosis based on their own research. Others may have had medical appointments to figure out their symptoms, perhaps without receiving any clear answers.

If you are experiencing orthostatic intolerance (feeling unwell when standing up), these are the main four steps you might expect when you see your doctor.

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1. Good medical care begins with a conversation.

Your doctor will want to understand more about you and the symptoms you have been experiencing.

What have you been feeling? When did this begin? How often does it happen? Are there things that make you feel better or worse?

With the information that you share, your doctor will formulate a “ differential diagnosis ”, which is a list of possible conditions based on your symptoms. As an example, if you told your doctor that you have a red bump on your chin, the differential diagnosis could include acne , but also insect bite.

2. Your doctor will do a physical examination.

In this part of the visit, your doctor is trying to uncover more clues to narrow the list of possible conditions that explain your symptoms. In the case of suspected POTS, one major component of the examination is obtaining measurements of your heart rate and blood pressure when you sit compared to when you stand. In a virtual appointment your doctor will guide you on how to obtain these measurements accurately and safely.

3. You will probably need an electrocardiogram (ECG).

This is a test that measures the electrical activity of your heart. It will help the doctor determine whether your heart is beating in a normal pattern. At home, your doctor can help you obtain this via an Apple Watch or another hand-held device.

4. A visit to the lab may be necessary.

Your doctor may request blood tests to ensure the evaluation is thorough. The testing will usually be a combination of basic lab tests (which you may have already completed for another reason) and other specialized lab tests (these will vary depending on the symptoms you have and the findings of your physical examination).

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All of the information gathered through these four steps will help you and your doctor design a personalized care plan. Sometimes the plan will include other testing or continued follow ups to support you in finding a path to a better quality of life.

If you or someone you know is having difficulties with orthostatic intolerance, check out Empirical Health.