Postural tachycardia syndrome (POTS) is a condition in which a person’s heart rate increases significantly upon standing up. This can cause dizziness, fainting, and other symptoms. POTS is often caused by a dysfunction of the autonomic nervous system, which controls the body’s automatic functions such as heart rate and blood pressure. It can also be triggered by certain medications, infections, or other underlying medical conditions.
The main symptom of postural tachycardia syndrome (POTS) is an increase in heart rate upon standing up. This can cause a number of additional symptoms, including:
- Dizziness or lightheadedness
- Fainting or near fainting (syncope)
- Palpitations (feeling like your heart is racing or skipping a beat)
- Chest pain
- Shortness of breath
- Blurred vision
- Excessive sweating
- Difficulty concentrating
- Mood changes such as anxiety or depression
Some people with POTS may also experience symptoms such as tremors, difficulty concentrating, and mood changes. These symptoms may be more pronounced when standing up and can improve when lying down. POTS can also cause difficulty with physical activities, such as standing for long periods of time or exercising.
What causes Postural tachycardia syndrome
Postural tachycardia syndrome (POTS) is often caused by a dysfunction of the autonomic nervous system, which controls the body’s automatic functions such as heart rate and blood pressure. In POTS, the autonomic nervous system does not properly adjust the heart rate and blood pressure when a person stands up, leading to an increase in heart rate and a drop in blood pressure. This can cause the symptoms of POTS.
There are several factors that can contribute to the development of POTS, including:
- Certain medications, such as decongestants and antidepressants
- Infections, such as mononucleosis
- Physical trauma or surgery
- Nutrient deficiencies, such as low levels of iron or vitamin B12
POTS can also be associated with other underlying medical conditions, such as:
- Mitral valve prolapse
- Ehlers-Danlos syndrome
- Multiple sclerosis
Postural tachycardia syndrome (POTS) can affect people of all ages, although it is most commonly diagnosed in adolescents and young adults. Women are more likely to develop POTS than men, with the majority of cases occurring in women between the ages of 15 and 50.
There is some evidence to suggest that POTS may be more common in people with certain risk factors, such as:
- A family history of POTS or other autonomic nervous system disorders
- A history of physical trauma or surgery
- A history of infection
- A history of allergies
It is important to note that POTS is a complex and poorly understood condition, and the exact cause of POTS in any individual may not be clear.
Diagnosing Postural tachycardia syndrome
The diagnosis of postural tachycardia syndrome (POTS) is based on the presence of specific symptoms and a characteristic increase in heart rate upon standing up. To diagnose POTS, a healthcare provider will typically perform a physical examination and review the person’s medical history. They may also order certain tests to confirm the diagnosis and rule out other potential causes of the symptoms.
The most common test used to diagnose POTS is a tilt table test. During this test, the person is placed on a table that can be tilted to different positions. The person’s heart rate and blood pressure are monitored while they are in different positions (lying down, sitting, and standing). If the person’s heart rate increases significantly upon standing up and they experience symptoms of POTS, it is likely that they have POTS.
Other tests that may be used to diagnose POTS include:
- Blood tests to check for underlying conditions such as anemia or low levels of electrolytes
- Electrocardiogram (ECG) to check for abnormal heart rhythms
- Echocardiogram to assess the function of the heart
- Holter monitor to record heart rate and rhythm over a longer period of time
- Impedance cardiography to measure blood flow in the arms and legs
Treating Postural tachycardia syndrome
The treatment of postural tachycardia syndrome (POTS) is focused on reducing the symptoms of the condition and improving the person’s ability to function. Treatment may involve a combination of lifestyle changes, medications, and supportive therapies.
Lifestyle changes that may be helpful in managing POTS include:
- Increasing fluid intake and electrolyte intake (such as sodium and potassium)
- Wearing compression stockings
- Avoiding prolonged standing or sitting
- Gradually increasing physical activity
- Avoiding triggers that may worsen symptoms, such as hot temperatures or certain medications
Medications that may be used to treat POTS include:
- Fludrocortisone to help increase blood volume
- Midodrine to help increase blood pressure
- Beta blockers to help control heart rate
- Ivabradine to help control heart rate
Supportive therapies for POTS may include:
- Physical therapy to help improve strength and endurance
- Counseling to help manage the emotional impact of POTS
- Occupational therapy to help with daily activities and work-related tasks
Complications of Postural tachycardia syndrome
Postural tachycardia syndrome (POTS) can cause a number of complications, including:
- Fainting or near fainting (syncope): POTS can cause a significant drop in blood pressure upon standing, leading to fainting or near fainting. This can increase the risk of falls and injuries.
- Decreased physical activity: POTS can cause symptoms such as fatigue, dizziness, and shortness of breath, which can limit a person’s ability to engage in physical activity. This can lead to decreased muscle strength and endurance.
- Difficulty with daily activities: POTS can cause difficulty with activities such as standing for long periods of time or exercising. This can impact a person’s ability to perform their daily activities and potentially interfere with work or school.
- Emotional impact: POTS can also have an emotional impact, as the symptoms can be disruptive and difficult to manage. Some people with POTS may experience anxiety, depression, or other emotional difficulties as a result of their condition.
- It is important to work with a healthcare provider to manage the symptoms of POTS and prevent potential complications.
Preventing Postural tachycardia syndrome
- Staying well hydrated: Drinking plenty of fluids, particularly water, can help increase blood volume and improve symptoms of POTS.
- Getting enough electrolytes: Electrolytes such as sodium and potassium are important for maintaining normal heart function. Ensuring that you are getting enough of these nutrients through your diet or supplements may help improve symptoms of POTS.
- Gradually increasing physical activity: POTS can cause fatigue and other symptoms that may limit physical activity. However, gradually increasing physical activity can help improve muscle strength and endurance, which may improve symptoms of POTS.
- Wearing compression stockings: Compression stockings can help improve circulation and prevent blood pooling in the legs, which may help reduce symptoms of POTS.
- Avoiding triggers: Some people with POTS may find that certain factors, such as hot temperatures or certain medications, can worsen their symptoms. Avoiding these triggers can help improve symptoms.