Patients Arrive With Data
Instead of relying solely on subjective symptom reports, patients can bring objective heart rate measurements showing their orthostatic response.
Validated Protocol
POTS Check uses the NASA Lean Test, a peer-reviewed screening protocol that measures heart rate response to postural change.
PDF Reports for Review
Patients can generate detailed PDF reports showing baseline HR, standing HR, ΔHR, symptoms, and blood pressure (if recorded) for clinical review.
What Your Patients' Reports Include
Heart Rate Data
- Baseline (supine) heart rate
- Maximum standing heart rate
- Heart rate change (ΔHR)
- Time-series heart rate graph
Age-Based Analysis
- Age-appropriate threshold comparison
- Pediatric (13-19): ≥40 bpm threshold
- Adult (20+): ≥30 bpm threshold
- Clear indication of result
Blood Pressure (Optional)
- Pre-test blood pressure
- Standing phase BP readings
- OH detection (≥20/10 mmHg drop)
- OHT detection (≥20 mmHg increase)
Additional Data
- Timestamped symptom log
- Posture quality score
- Test date and duration
- Health Profile baseline (optional)
Clinical Methodology
NASA Lean Test Protocol
The app guides patients through a structured orthostatic test:
- Baseline Phase (5 minutes): Patient lies supine while heart rate is measured via Apple Watch
- Stand Transition (~20 seconds): Patient stands and leans against wall (feet ~6 inches away)
- Standing Phase (10 minutes): Continuous heart rate monitoring with optional BP readings at intervals
- Recovery Phase (1 minute, optional): Return to seated/supine position
Age-Based Thresholds
The app applies established POTS screening criteria:
- Adults (20+): Heart rate increase ≥30 bpm within 10 minutes of standing
- Pediatric (13-19): Heart rate increase ≥40 bpm within 10 minutes of standing
Posture Validation
The app uses iPhone motion sensors to validate that patients maintain proper positioning during the standing phase, providing a posture quality score to assess test reliability.
Important Clinical Note
POTS Check is a wellness screening tool, not a diagnostic device. Results indicate a "POTS-consistent pattern" or "non-POTS-consistent pattern" based on heart rate criteria. Clinical diagnosis requires comprehensive evaluation including ruling out other causes of orthostatic tachycardia.
Clinical Use Cases
Pre-Visit Screening
Patients can complete screening tests before their appointment, providing objective data to guide the clinical conversation.
Between-Visit Monitoring
Track how patients' orthostatic responses change over time with treatment, lifestyle modifications, or disease progression.
Tilt Table Wait Times
Patients waiting for formal tilt table testing can gather preliminary data while waiting for their appointment.
Post-COVID Evaluation
Screen Long COVID patients for POTS-like symptoms as part of post-viral dysautonomia workup.
Data Quality Considerations
Sensor Limitations
Apple Watch uses optical (PPG) heart rate sensing. Clinicians should be aware that:
- Accuracy may vary based on skin tone, tattoos, and watch fit
- Motion artifacts can affect readings during position changes
- Environmental factors (cold, dehydration) can influence results
- Consumer sensors are not FDA-cleared for medical diagnosis
Posture Quality Score
Each test includes a posture quality score (A-D) indicating reliability:
- A (Excellent): >90% stable posture, <5% artifacts
- B (Good): 70-90% stable, 5-15% artifacts
- C (Fair): 50-70% stable, 15-30% artifacts
- D (Poor): <50% stable or >30% artifacts (unreliable)
Blood Pressure Entry
Blood pressure data is manually entered by patients using their own BP cuff. Apple Watch does not measure blood pressure. Patients with a Secure Account can also import historical BP readings from Apple Health for baseline context.
Clinical Disclaimer
POTS Check is classified as a general wellness application, not a medical device. It is not FDA-cleared and should not be used as the sole basis for clinical decisions. Results are intended to supplement, not replace, clinical evaluation. The app provides informational screening results only and explicitly states it does not diagnose POTS or any medical condition.
Recommend POTS Check to Your Patients
POTS Check is completely free with no subscriptions or in-app purchases. Patients need an iPhone (iOS 18.6+) and Apple Watch (watchOS 11.0+) to use the app.
App ID: 6754960172
Questions or Feedback?
We welcome clinical feedback and questions from healthcare providers.