Editorial: Recent advances with orthostatic intolerance/tachycardia in children and adolescents: international perspectives

Huynh P et al. (9) conducted a systematic clinical review examining the available pharmacological treatments for pediatric POTS. Although no FDA-approved therapies exist for this age group, his analysis suggested that medications such as ivabradine, midodrine, beta-blockers, and fludrocortisone may provide symptom relief in selected cases. However, authors also noted that pediatric treatment decisions are often extrapolated from adult data, and called for dedicated pediatric trials. Taken together, these studies highlight the growing consensus that pediatric POTS is a multi-system condition with autonomic, immunologic, psychological, and possibly genetic components. They also reflect an international effort to refine the diagnostic process, develop predictive tools, and personalize therapy. Importantly, the need for multidisciplinary care is emphasized, spanning pediatric cardiology, neurology, immunology, mental health, and education systems.The psychosocial impact of OI in youth is another recurring theme. Adolescents with POTS often experience stigma, delayed diagnosis, and school disruption. Innovative solutions, such as school-based reconditioning programs and family-centered education, show promise in addressing these challenges and improving quality of life. Looking ahead, several research directions are clear. Large-scale longitudinal studies incorporating biological and psychosocial data are needed to better understand the disease trajectory. The development of pediatric-specific diagnostic criteria and evidence-based treatment guidelines remains a top priority. Additionally, wearable digital technologies and machine learning tools may enable earlier recognition and real-time symptom tracking. In conclusion, this Research Topic reflects the international momentum toward improving care for children and adolescents with orthostatic intolerance. The contributions of authors collectively offer new perspectives and practical solutions to a complex and often misunderstood condition. Their work fosters a shared vision: to ensure that every child with OI or POTS receives timely recognition, individualized care, and hope for recovery.