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For people living with postural orthostatic tachycardia syndrome, or POTS, the simple act of standing up can cause a cascade of symptoms: a racing heart, lightheadedness, brain fog, shakiness and exhaustion. Yet a standard cardiac test may appear completely normal.

That disconnect is at the center of a new call to action from an international group of POTS experts, including Dr. Blair Grubb, distinguished university professor of medicine and pediatrics and director of the Cardiac Electrophysiology and Autonomic Disorders programs at The University of Toledo.

The group's perspective, "Managing POTS: A Cardiovascular Call to Action," was published in the Journal of the American College of Cardiology.

Led by Dr. Marat Fudim of Duke University, the paper also includes co-authors Dr. Satish Raj of the University of Calgary, Dr. Artur Fedorowski of the Karolinska Institutet, Dr. Stavros Stavrakis of the University of Oklahoma and Elisabetta Burchi of Rome.

The authors call on cardiologists to improve how they recognize, diagnose and manage POTS, a condition in which the body has difficulty regulating blood flow and heart rate when a person stands.

5 liters) of blood down into our legs and belly, and the autonomic nervous system, the body's automatic control system, instantly tightens the blood vessels to push that blood back up to the heart and brain," Grubb said.

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