I've heard sometimes it can go in remission. I think with some, it may get worse- I was diagnosed with P.O.T.S. more than six years ago and I don't know that it's gotten a whole lot worse. My holter monitor high number was up 8 beats per minute compared to the one about two years previous. But the heart's capacity when exercising at my age I believe is still more than the 160 my heart rate got to standing up from laying down. One key I think is to keep doing as much non-strenuous upright activity as you can to try to prevent your orthostatic intolerance from getting even worse.
I also heard people saying they got worse as time goes on. Is this true? I dont want to get worse, Im looking to get better. Sometimes it seems hopeless.
There is still research going on trying to figure out things about P.O.T.S.... they don't have all the answers at this time. You might see if you could get a standing norephinephrine blood test.
The tests that I had done were EKG, Echocardiagram, tilt test, and stress test. Also blood tests including vitamin D, thyroid, sugar and more that I can't remember. I was also made to wear a holter monitor(spelling?)