Abstract
BACKGROUND: Postural orthostatic tachycardia syndrome (POTS) is a disorder characterized by orthostatic intolerance, tachycardia, and syncope. Ivabradine, though not Food and Drug Administration approved for POTS, has shown promise in its management. CASE SUMMARY: A 20-year-old woman with POTS, complicated by multiple comorbidities, experienced a severe functional decline. Standard therapies were ineffective. Given the presence of apical trabeculations and severe tachycardia, ivabradine was initiated, leading to rapid and sustained improvements in her symptoms. DISCUSSION: This case highlights the effectiveness of ivabradine in patients with complex POTS who have failed conventional treatments. The patient's dramatic recovery underscores its potential to enhance quality of life. While previous studies support the efficacy of ivabradine in treating POTS, this case reinforces it as a viable treatment option and adds real-world evidence for its inclusion in treatment guidelines. TAKE-HOME MESSAGE: As the understanding of POTS evolves, incorporating ivabradine into treatment guidelines could expand therapeutic options and improve patient outcomes, particularly in refractory cases.