POTS Questionnaire

MAPS - Malmö POTS Score Assessment

Instructions

This questionnaire concerns symptoms related to postural orthostatic tachycardia syndrome (POTS). It will help us to evaluate how affected you are by symptoms originating from this syndrome.

Please circle the number on the following scale that corresponds to your average symptoms for the past week. You should only answer once per question. If you haven't experienced symptoms described below, circle zero (0).

Scale: 0 = No symptoms, 10 = Pronounced symptoms

POTS Symptom Assessment (12 Questions)

Question 1
Dizziness in upright position or while standing up
No symptoms Pronounced symptoms
Question 2
Dizziness, feeling that you are going to faint
No symptoms Pronounced symptoms
Question 3
Palpitations, high pulse, or feeling heart beating irregularly
No symptoms Pronounced symptoms
Question 4
Difficult breathing/dyspnoea, both at effort and rest
No symptoms Pronounced symptoms
Question 5
Chest pain
No symptoms Pronounced symptoms
Question 6
Headache
No symptoms Pronounced symptoms
Question 7
Concentration difficulties and/or problems with thinking
No symptoms Pronounced symptoms
Question 8
Muscle pain
No symptoms Pronounced symptoms
Question 9
Nausea
No symptoms Pronounced symptoms
Question 10
Gastrointestinal problems (stomach-ache, diarrhoea, constipation)
No symptoms Pronounced symptoms
Question 11
Abnormal tiredness that persists after rest
No symptoms Pronounced symptoms
Question 12
Insomnia
No symptoms Pronounced symptoms

POTS Assessment Results

0

Total MAPS Score (out of 120)

Clinical Information

In a study of 62 POTS patients versus 50 healthy controls, the optimal cut-off value to discriminate between POTS and healthy controls was a total MAPS score of ≥42, yielding excellent sensitivity (97%; 95% confidence interval [CI] 0.89—0.99) and specificity (98%; 95% CI 0.89—0.99).

Recommendations

Important Disclaimer: This questionnaire is a screening tool and should not be used as a substitute for professional medical diagnosis. The results should be interpreted by a qualified healthcare provider in the context of clinical evaluation and other diagnostic tests. For more information on POTS, visit www.potsfoundation.org.au