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BackTable / VI / Podcast / Episode #460

What is POTS and Orthostatic Flow Syndrome?

with Dr. Steven Smith

Dr. Ally Baheti interviews interventional radiologist Dr. Steven Smith about his insights into venous orthostatic flow dysfunction and its association with multisystem disorders.

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What is POTS and Orthostatic Flow Syndrome? with Dr. Steven Smith on the BackTable VI Podcast)
Ep 460 What is POTS and Orthostatic Flow Syndrome? with Dr. Steven Smith
00:00 / 01:04

BackTable, LLC (Producer). (2024, June 28). Ep. 460 – What is POTS and Orthostatic Flow Syndrome? [Audio podcast]. Retrieved from

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Podcast Contributors

Dr. Steven Smith discusses What is POTS and Orthostatic Flow Syndrome? on the BackTable 460 Podcast

Dr. Steven Smith

Dr. Steven Smith is a vascular and interventional radiologist with UChicago Medicine in Hinsdale, Illinois.

Dr. Aparna Baheti discusses What is POTS and Orthostatic Flow Syndrome? on the BackTable 460 Podcast

Dr. Aparna Baheti

Dr. Aparna Baheti is a practicing Interventional Radiologist in Tacoma, Washington.


Dr. Smith details his clinical career and his surprising findings that connect pelvic congestion syndrome with a range of other conditions, such as postural orthostatic tachycardia syndrome (POTS), chronic fatigue syndrome, Ehlers-Danlos syndrome, irritable bowel syndrome (IBS), vulvodynia, interstitial cystitis, and fibromyalgia. For patients with venous manifestations, he pursues treatment with stents or embolization, taking a proactive approach to targeting any abnormal vasculature that he identifies.

Additionally, the podcast delves into the physiological basis of POTS and related disorders, which mainly stems from blood pooling in the lower body, leading to sympathetic overactivation. Overall, Dr. Smith emphasizes the significance of collaborating with specialists across different disciplines to advance understanding and treatment of these complex syndromes.


00:00 - Introduction
03:11 - Symptom Constellation of Venous Orthostatic Flow Syndrome
12:08 - Pelvic Vein Treatment Algorithm
21:08 - Physiology of Orthostatic Intolerance and Sympathetic Overdrive
27:11 - Patient Selection
33:27 - Need for Research and Collaboration
36:07 - Advocacy for Patients


BackTable VI Ep. 337- Management of Vulvar Varices with Dr. Brooke Spencer

BackTable VI Ep. 33- Building a Comprehensive Vein Practice with Dr. Brooke Spencer & Dr. Isabel Newton

An online survey of pelvic congestion support group members regarding comorbid symptoms and syndromes (Smith et al, 2022):

Distension of central great vein decreases sympathetic outflow in humans (Cui et al, 2013):

Orthostatic intolerance and chronic fatigue syndrome: New light on an old problem (Rowe, 2002):

Disclaimer: The Materials available on are for informational and educational purposes only and are not a substitute for the professional judgment of a healthcare professional in diagnosing and treating patients. The opinions expressed by participants of the BackTable Podcast belong solely to the participants, and do not necessarily reflect the views of BackTable.

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