Table 2.

Evaluation Overview for the Pregnant Patient with New Onset POTS Symptoms

Evaluation method:
Thorough history	symptoms pre-pregnancy symptoms and disorders medications dietary habits fluid intake any other triggers that may be associated with new-onset POTS, such as a viral illness, concussion, or immunization
Physical exam	includes a 10-minute stand test with supine and standing blood pressure and heart rate measurements
Cardiovascular and neurologic exams	evidence of a heart murmur cardiomegaly pupillary dysfunction loss of temperature and pain sensation in the extremities
Laboratory tests	CBC CMP TSH free T4 ferritin morning cortisol vitamin B12 BNP serum autoimmune panel comprehensive vitamin and nutrient panel
Diagnostic tests	EKG 2D cardiac echocardiogram 24-hr Holter monitor
If headache is present:	Consider MRI of the brain without contrast if: - Headache is different or new compared to pre-pregnancy headache - Any focal neurologic deficits are present - There is abnormal neurologic exam - Headache is accompanied by blood pressure elevation