van der Zalm, T, Alsma, J, van de Poll, S W E et al. · The Netherlands journal of medicine · 2019
POTS is a condition where standing up quickly causes your heart to beat much faster than normal, and you may feel dizzy, tired, or unwell. This paper describes two different patients with POTS to show how differently the condition can appear from person to person. The authors explain that POTS can overlap with chronic fatigue syndrome and suggest that simple treatments like drinking more water and salt, along with exercise, often help before considering medications.
Understanding POTS is important for ME/CFS patients because the two conditions frequently co-occur and share overlapping symptoms like orthostatic intolerance and fatigue. Recognizing and appropriately treating POTS may improve outcomes in patients with ME/CFS who have cardiovascular dysregulation. This article highlights the need for clinician awareness of POTS as a distinct but related condition requiring targeted management.
This case report does not establish the prevalence of POTS in ME/CFS populations or prove that POTS causes ME/CFS or vice versa. It does not provide controlled comparison data on treatment efficacy, nor does it clarify the mechanistic relationship between POTS and ME/CFS. The small number of cases limits generalizability of findings.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
The first block is for the primary paper and is the citation you should use in research work. The atlas-snapshot line only applies if you are specifically referring to this atlas’s reading of the paper on the date shown.
Primary citation
van der Zalm, T, Alsma, J, van de Poll, S W E, Wessels, M W, Riksen, N P, & Versmissen, J (2019). Postural orthostatic tachycardia syndrome (POTS): a common but unfamiliar syndrome.. The Netherlands journal of medicine. https://pubmed.ncbi.nlm.nih.gov/30774097/
BibTeX
@article{mecfsatlas-van-der-zalm-2019-postural-orthostatic,
author = {van der Zalm, T and Alsma, J and van de Poll, S W E and Wessels, M W and Riksen, N P and Versmissen, J},
title = {Postural orthostatic tachycardia syndrome (POTS): a common but unfamiliar syndrome.},
journal = {The Netherlands journal of medicine},
year = {2019},
note = {PubMed: 30774097},
url = {https://www.mecfsatlas.com/evidence/van-der-zalm-2019-postural-orthostatic},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-26. https://www.mecfsatlas.com/evidence/van-der-zalm-2019-postural-orthostatic
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