Syncope and POTS

Fainting and dizziness in children are usually not life‑threatening but should be evaluated to understand their cause. Our pediatric cardiology team diagnoses and treats syncope (fainting) and postural orthostatic tachycardia syndrome (POTS) to help children feel better and remain active.

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Fainting and lightheadedness upon standing are common in children and teens, most often due to vasovagal syncope — a harmless reflex that briefly lowers heart rate or blood pressure — or postural orthostatic tachycardia syndrome (POTS), which involves an excessive rise in heart rate upon standing.

At University of Iowa Health Care Stead Family Children’s Hospital, our pediatric cardiology team provides expert evaluation and ongoing care for children with fainting and orthostatic symptoms. From initial diagnosis to long‑term management, our specialists will partner with you to support stability, health, and recovery for your child at every stage.

Syncope and POTS symptoms

Your child may have syncope or POTS if they experience:

Dizziness or lightheadedness

Fainting or almost fainting

Fatigue or weakness

A prolonged fast heartbeat when standing

Nausea, especially in the morning

Headaches

To find out what’s going on, our team takes time to understand your child’s symptoms and medical history.

How we diagnose syncope and POTS

Your child’s care team will first review their health history, symptoms, and perform a thorough physical examination.

They may also ask your child to complete a tilt table test that measures your child’s heart rate and blood pressure while lying down, sitting, and standing. This test helps your child’s care team notice any changes in blood pressure that may indicate POTS. It involves:

Your child lies flat for 5 minutes.
We measure heart rate and blood pressure while lying down.
Then your child sits up, and we take new measurements.
Finally, they stand still for 10 minutes while we record readings immediately upon standing, and again at 5 and 10 minutes.

If further tests are needed, they may also recommend:

Blood tests. These tests can check for vitamin, thyroid, iron, or electrolyte imbalances that could contribute to symptoms.

Echocardiogram (echo). An ultrasound to observe the heart’s structure and function to check the structure of the heart.

Electrocardiogram (EKG). A short test that records the heart’s electrical activity and looks for abnormal heart rhythms.

Holter monitor. A wearable heart monitor that records your child’s heart rate, helping to determine if it’s beating at the correct rhythm.

Treatment for syncope and POTS

Our team will tailor your child’s treatment based on their needs and monitor progress closely. Your child's treatment will most likely begin with small but powerful lifestyle changes. These include:

Staying hydrated. For teens, that’s about 100–120 ounces of water each day.

Exercising regularly. Aim for 5 days a week to build endurance and improve circulation.

Increasing salt intake. If symptoms don’t improve after a month of good hydration, we may suggest adding salt through healthy foods or supplements.

With time and consistency, most children start to feel stronger and experience fewer dizzy or fainting episodes.

If symptoms continue, your child’s care team may also recommend:

Compression stockings to prevent blood from pooling in the legs

Physical therapy to improve strength and circulation

Medications (used only when needed) to manage heart rate or blood pressure

Ongoing care and everyday support

How often you’ll visit our pediatric cardiology team depends on how your child responds to treatment. If physical therapy or medication is needed, we’ll schedule more frequent visits to track improvements and make any necessary adjustments.

We also help your child succeed in school. Our team can provide letters that allow them to carry a water bottle, salty snacks, or take bathroom breaks when needed, so they can stay hydrated, focused, and comfortable throughout the day.

The good news is that most teens with POTS improve significantly as they get older. As your child adopts healthy habits, matures, and life becomes less stressful, their symptoms often fade or disappear completely.

Our Care Team

Our pediatric cardiology providers work closely with you and your family to create a plan that helps your child feel their best and get back to doing what they love.