Table 2.

Supported self-management for postural tachycardia syndrome¹^,³

Method	Rationale	Comment
Avoid symptom triggers	To reduce vasodilation and venous pooling	Triggers include hot environments, prolonged standing, heavy meals, and alcohol
High fluid intake	Increase blood volume	3 l/day in adults
Additional salt (unless contraindicated)	Increase blood volume and pressure	10 g/day in adults, less in children
Lower body compression	Reduce venous pooling	Waist high, class 2. If not tolerated, sports compression clothing may help
Exercise	To strengthen skeletal muscle pump and prevent deconditioning	Start with low-level recumbent exercise
Counterpressure manoeuvres	Activating skeletal muscle pump to increase venous return/prevent syncope	Cross legs and squeeze thigh muscles, clench buttocks, and tightly fold arms
Sleep in a head-up tilt position (>10°)	To expand blood volume	Bricks under head end of bed
Pacing of activities	To regulate activity to achieve adaptive goals	To reduce severity of flares and fatigue
Psychotherapy	To help patient adjust to chronic illness and frightening symptoms	Cognitive behavioural therapy and mindfulness