356 - Managing Postural Orthostatic Tachycardia Syndrome: Essential Knowledge for Pediatric Dentists

Abstract: Background

Postural Orthostatic Tachycardia Syndrome (POTS) is a chronic autonomic disorder characterized by excessive heart rate increase upon standing, most often manifesting in adolescent females. Common symptoms include lightheadedness, fatigue, palpitations, and syncope. Although well described in medical literature, practical guidance for dental teams, particularly in pediatric settings, remains limited. The objective of this literature review was synthesize current evidence and translate it into chairside, team‑based strategies for safe, patient‑centered pediatric dental care.

Methods

Review of published reports on POTS demographics, diagnostic features, comorbidities and management approaches over the past 20 years was conducted using PubMed®/ MEDLINE electronic database using the terms: postural, orthostatic, tachycardia, syndrome, dental; fields: all; limits: within the last 20 years, English. to determine dental implications. Four articles matched all criteria, with 1551 discussing the syndrome since 2006 including 38 systematic reviews and meta-analyses.

Results

Across case reports and observational studies, POTS diagnosis is supported by orthostatic tachycardia, occasional elevated norepinephrine, and reduced heart‑rate variability. Management varies including hydration, salt repletion, compression, graded exercise, pharmacotherapy such as ivabradine in selected cases. Evidence suggests POTS after COVID‑19 vaccination is reported but less likely than after SARS‑CoV‑2 infection. Studies are limited by small samples and methodological variability.

Conclusions

As pediatric dentists encounter the affected demographic, education of pediatric dentists regarding clinical features of this diagnosis, risk of syncope along with clinical management are vital to positive clinical outcomes.



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