Nonpharmacologic treatments for postural tachycardia syndrome
| Therapy | Dosage | Pathologic mechanisms addressed | Potential drawbacks | Comments |
|---|---|---|---|---|
| Exercise | ≥ 30 min at least 3 times a week | All | Worsened symptoms at the outset, prolonged fatigue | Gradually progress from non-upright to upright endurance and resistance exercises |
| Dietary fluid | 2–3 L per day | All | Hyponatremia | |
| Dietary salt | 10–12 g per day | All | Difficult to augment sufficiently through diet alone | Supplement with sodium chloride tablets, if necessary |
| Salt tablets | 1 g tablet 3 times daily | Hypovolemia | Poor taste, nausea, dyspepsia | Recommended for use after meals |
| Acute intravenous normal saline | 1 L over 1–3 hours | Hypovolemia | Inconvenient, medical setting required | Heart Rhythm Society Consensus Statement class IIa recommendation (benefit probably exceeds risk) |
| Chronic intravenous normal saline | 1 L every 2 days | Hypovolemia | Access complications and infection with central line | Heart Rhythm Society Consensus Statement class III recommendation (recommends against) |