Syncope (blackouts) and Postural Tachycardia Syndrome (PoTS) Service

The syncope and Postural Tachycardia Syndrome (PoTS) service is part of the Cardiac Rhythm Management (CRM) service. Working within the service are consultant cardiologists and nurse specialists.

Patients are referred into the syncope or PoTS clinics when their doctor or health care professional feels that you have had a blackout or thought to have Postural Tachycardia Syndrome.

What is syncope (blackouts)?

Syncope (also called fainting or passing out) is temporary loss of consciousness due to a sudden drop in blood flow to the brain. It is a common problem, both in young and older people.

What is Postural Tachycardia Syndrome (PoTS)?  

Postural tachycardia syndrome (PoTS) is an abnormality of the functioning of the autonomic (involuntary) nervous system. It is defined as an increase in heart rate of over 30 beats per minute (or higher than 120 beats per minute / 40 bpm in those age 12-19) when standing upright. Patients get many symptoms for example syncope, dizziness and palpitations.

Our team

  •  Dr John West Consultant Cardiologist
  •  Dr Jonathan Sahu Consultant Cardiologist
  •  Ms Melloney Ferrar Nurse Specialist
  •  Ms Sarah Odams Nurse Specialist
  •  Ms Anna Gregory Nurse Specialist

Information for patients

We run several consultant and nurse specialist clinics during working hours at the Royal Hallamshire Hospital.

All patients who are referred to the Syncope and PoTS service will see a nurse specialist on their first appointment. The nurse specialists who work in the service have a lot of experience in looking after with patients who blackout or who have PoTS.

Patients will not see a doctor on the first visit. After the clinic, patients are discussed with the Consultant. If at any time the nurse specialist feels that a patient needs to see a doctor then this will be arranged.

Patients should bring the following items to the clinic appointment
 After the initial clinic visit the following may happen
  • A decision will be made as to whether there is need to be seen by a doctor, continue being seen by the nurse specialists, or whether the patient should be discharged
  • Appointments will be sent for appropriate tests
  • Patients may be asked to increase the amount of fluids and/or salt they take, the nurse will inform the patient of this during their initial appointment
  • Patients will be sent a letter regarding any further appointments through the post

At the follow up appointment we will assess whether any lifestyle changes have made a difference to patients symptoms. We will also discuss the results of any tests we have done.

If you feel dizzy or faint here’s what to do
  • Act quickly, as soon as you feel your symptoms coming on
  • Sit down immediately
  • If possible, lie down flat
  • Put your legs in the air, for example against a wall
  • When you feel well again, get up cautiously. However, if you have further symptoms you may need to lie down again

Information for GP’s and referring doctors

Prior to the patients’ appointment for the syncope / PoTS clinic it is useful for the following tests to have been performed and the results be available to us.

  • Urea and electrolytes
  • Liver function tests
  • Thyroid function tests
  • Full Blood Count
  • Vitamin B12, ferritin, folate
  • Vitamin D

If the patient has had other tests, which may not be available to us, please could you provide the results of these with the referral.

The following would be useful for PoTS patients only.

  • 24 Hr urines for free metanephrines, catecholamines, 5HIAA
  • If available full Tilt Table report, Echocardiograph and full 24 hr Holter report.

If it is strongly suspected that the patient has either reflex syncope of POTS patients can be advised the following.

  • Maintain good hydration – 3 litres clear fluid per day, cut down caffeine and alcohol intake
  • Additional salt to diet – at least a teaspoon per day
  • Grade 2 compression tights or stockings to be worn whilst active during the daytime

Further Information and Leaflets

You will find links to information and patient guides regarding Syncope and PoTS below.
Each of the links opens in a new page so you will still be able to look around our website once you have clicked on a name.
These links are to trusted sources however the information is provided to support the consultation you have with your doctor and is not intended that this information would replace the need for a face to face meeting.

STARS Booklets

Blackouts Checklist
Diagnostic tests for syncope
Frequently asked questions
Living with low blood pressure
Postural tachycardia syndrome
Psychogenic blackouts
Reflex anoxic seizures (RAS)
Reflex syncope

STARS Leaflets

Postural tachycardia syndrome (PoTS)
Syncope during pregnancy
Syncope in older people: Common causes and advice
Syncope and diet: You are what you eat


Other Sites

Syncope Trust and Reflex anoxic Seizures STARS

"Working together with individuals, families and medical professionals to offer support and information on syncope and reflex anoxic seizures"


"PoTS UK was founded by a group of individuals with PoTS who had a desire to increase awareness of this condition. We now benefit from the support and guidance of a number of doctors and specialist nurses with an interest in this field."

HMSA- Hypermobility Syndromes Association

"The HMSA provides information on the Heritable Disorders of Connective Tissue (the ‘Hypermobility Syndromes’) through its website, publications, forums, local groups, advice line, and education programmes."


"We aim to offer helpful information, incorporating current thinking and explanations from those who specialise in these conditions, together with details of centres for patient referral, useful links, and references for further study.  We have also included articles, which we hope will inspire, enlighten or simply ‘strike a chord' with those who are symptomatic, or care for someone who is."

Dysautonomia International

We are a non-profit making organisation founded in 2012 by patients, caregivers, physicians and researchers dedicated to assisting people living with various forms of dysautonomia.


Additional Information

How to contact us

We can be contacted on 0114 226 9184, this is an answerphone. We do our best to answer queries promptly, but clinical care of patients will always take a priority.



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