Postural Orthostatic Tachycardia Syndrome (POTS) is a variant of cardiovascular autonomic disorder characterised by an excessive heart rate on standing and orthostatic intolerance. We present a rare case of a 38-year old man who underwent open repair of a thoracoabdominal aortic aneurysm (TAAA) for a chronic Stanford type B aortic dissection whose recovery was complicated by POTS. He was received blood transfusions, and was commenced on metoprolol, fludrocortisone and ivabradine with significant improvement in his symptoms.