Virtual Curbside

In this Q&A episode of our Postural Orthostatic Tachycardia Syndrome (POTS) series, host Paul Wirkus, MD, FAAP and guest Kirti Sivakoti, MD, answer listener questions about diagnosing and managing POTS in pediatric patients. The discussion explores how to distinguish POTS from conditions with overlapping symptoms, including Mast Cell Activation Syndrome (MCAS) and other common POTS mimics, and when referral to an immunologist may be appropriate.We also review commonly used medications for symptom management, including practical considerations for initiating and tapering therapy as patients improve. Additional topics include the effects of caffeine, stimulant medications, ADHD treatments, and vasoconstrictors on orthostatic symptoms, helping clinicians navigate treatment decisions in children and adolescents with complex presentations.Throughout the episode, Dr. Sivakoti emphasizes the importance of individualized care, careful assessment, and ongoing follow-up to optimize outcomes for patients living with