A structured POTS evaluation integrates symptoms, heart rate, blood pressure, duration, exclusions, and appropriate stand or tilt testing. A heart-rate rise is only one part of the diagnosis.

Some patients experience symptoms that persist even after appropriate medical evaluation. The phrase “medically unexplained” can sound discouraging, but it does not mean the symptoms are imaginary.

Multiple symptoms, no diagnosis — an internal medicine perspective on why symptoms can affect several body systems at once even when each individual test returns normal.