Intro POTS is said to be a type of dysautonomia characterized by Tachycardia brought about by postural shifts in blood volume and circulation. This results in various Symptoms (Sx) including dizziness, lightheadedness, syncope, palpitations and tremulousness. POTS is often associated with EDS, a rare inherited connective tissue disorder pertaining to the production and processing of collagen. POTS causes abnormal increases in HR. If left untreated, pts can suffer from TIC indicated by an increasing Left Ventricle End Diastolic Diameter (LVEDD). Methods Electronic health records of 1300 POTS pts were reviewed retrospectively. Female pts with EDS between the ages of 20-40 who had imaging records of 3 or more echocardiograms in the past 5 yrs, with no more than 1 yr between consecutive echocardiograms were randomly selected. Our records identified 94 pts fulfilling this criteria. An assessment of the relation between associated Sx and corresponding Echocardiogram LVEDD values was made by observing pts reported Sx such as shortness of breath, chest pain, dizziness/lightheadedness, palpitations, and their overall feeling of well-being. Corresponding Functional Capacity (FC) values of each pt analyzed by reviewing Cardiopulmonary Exercise Stress Tests were also noted. Lastly, treatment modalities including drugs, exercise and I/V fluids were also monitored. A timeline with regards to changes in LVEDD was established to determine the effectiveness of various treatments. Results Of the 94 pts fulfilling the inclusion criteria: Mean age was 30 +/- 6.3 yrs. Mean LVEDD of pts reporting min Sx was 4.02 +/- 0.43. Mean LVEDD of pts reporting max Sx was 4.28 +/- 0.45. T-Test (p-value The average FC of pts experiencing min Sx was 69% while it was 63% for pts experiencing max Sx. T-Test (p-value = 0.006665) indicates that the mean of FC with least Sx is significantly higher than FC with maximum Sx. The average Decrease in FC per 0.1 cm Increase in LVEDD was 2.55% Pts with LVEDD of 4.04 +/- 0.48 were seen to have the highest FC >70%. Overall, 40 pts were seen to have >70% FC at LVEDD with the Lowest Sx. At >70% FC, 44 pts showed improvement with medication (Midodrine 20, Florinef 12, Beta Blockers 12), 25 pts with exercise and 11 on IV Fluids (including saline and/or albumin infusions). Conclusion Pts with POTS and EDS, tend to develop a worsening of Sx as LVEDD progressively increases resulting in a Tachycardia Induced Cardiomyopathy. However, aggressive management of Sx with medication and a dedicated exercise regimen can improve Sx, decrease LVEDD and cause reversal of the disease process. From the evidence collected, it can be recommended that POTS pts’ LVEDD values be maintained between 3.8 - 4.2 cm, as this range was seen to produce the least amount of Sx as well as a higher FC (>70%).