Long COVID Atlas
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Education, not medical advice. Tests and their interpretation belong with your own clinician.

Diagnostic · Autonomic

NASA lean / active stand test

The most practical test for orthostatic symptoms: lie down, stand up, and measure what happens to heart rate and blood pressure over several minutes. It needs almost no equipment, which is exactly why it is the one most likely to get done and to document POTS.

Short version: the active-stand test measures heart rate and BP from lying to standing, capturing POTS and orthostatic intolerance with no special equipment. Accessible and first-line.

A test you can almost do anywhere

The active-stand (or NASA lean) test measures heart rate and blood pressure lying down, then across several minutes of standing. It needs no tilt table, just a cuff, a clock, and care, which makes it widely usable for POTS and orthostatic intolerance.1

What standing up does Lying downheart rate about 72,blood spread evenly stand up Standingblood pools in the legs;to compensate the heartraces 30+ beats faster POTS = the racing heart on standing;orthostatic intolerance = dizzy, foggy, faint upright
Standing is a small cardiovascular stress test. Gravity pulls blood into the legs, and the body must tighten vessels and adjust heart rate to keep the brain supplied. When that reflex misfires, the heart compensates by racing (POTS) and the brain is briefly under-supplied, felt as dizziness, lightheadedness, and fog on standing.

What it captures

It documents the sustained heart-rate rise of POTS and the blood-pressure behavior of orthostatic intolerance, the same core information as tilt testing for most people, in a clinic room or even at home under guidance.1

accessible first-line

Why it matters

Because it is simple, it is the test most likely to actually get done, turning a dismissed symptom into a documented finding that justifies treatment and links to dysautonomia.

What we don't know

Honest about the edges of the evidence. These are open questions, not settled answers.

  • How home stand-testing compares with clinic testing.
  • Best protocol duration.
  • How it should trigger treatment.

References

Every reference is free to read in full.

  1. Stand-based autonomic assessment in long COVID dysautonomia.

Associated topics