Learn More About POTS

POTS — Postural Orthostatic Tachycardia Syndrome

  • Postural Orthostatic Tachycardia Syndrome (POTS) is a disorder of the autonomic nervous system that mainly effects the cardiovascular system but can also effect other systems such as the gastrointestinal system. POTS can cause extreme tachycardia upon standing, exercising, and sometimes without any postural change. While some people may faint often with POTS it is also possible to have POTS without syncope.

    Breakdown of what POTS means:

    • Postural — the position of the body

    • Orthostatic — standing upright

    • Tachycardia — heart rate over 100 bpm

    • Syndrome — a group of symptoms present together

    The automatic nervous system is responsible for regulating heart rate and blood pressure amongst many things. With POTS, the body experiences a malfunction in the autonomic nervous system causing a heart rate and, sometimes, a blood pressure imbalance.

    POTS, along with at least 14 other conditions fall under the umbrella category of Dysautonomia. While men can be affected by POTS, the majority of patients (75%-80%) affected are female. POTS affects roughly 0.2% of the population.

    Certain factors also make a person more likely to develop POTS. These factors include, but are not limited to:

    • viral illness (mononucleosis or infections)

    • pregnancy

    • head trauma

    • surgery

    • certain autoimmune conditions put patients at a greater risk of developing POTS

    There are currently three known causes of POTS, though current research suggests POTS might be autoimmune related. The three known causes are as follows:

    • Neuropathic POTS

    • Hyperadrenergic POTS

    • Hypovolemic POTS

  • Symptoms of POTS vary from person to person. Symptoms of POTS include, but are not limited to:

    • dizziness (especially upon standing)

    • pre-syncope

    • fainting

    • brain fog

    • heart palpitations

    • shakiness

    • excessive sweating

    • fatigue

    • anxiety

    • shortness of breath

    • chest pain

    • headaches

    • bloating

    • blood pooling in limbs

  • The diagnosis of POTS is made after obtaining a detailed patient history, evaluating patient symptoms, and a test known as a Tilt Table Test.

    During a Tilt Table Test the patient lays flat on a table and their vitals are taken. Next, the patient is tilted into an upright position and vitals are taken again. A positive Tilt Table Test for POTS displays a heart rate increase of 30 or more beats per minute within 10 minutes of being in an upright position. It is important that Orthostatic Hypotension or Orthostatic Hypertension be ruled out before a POTS diagnosis.

  • Treating POTS looks different for everyone, however, treatment can look like:

    • Increasing sodium intake

    • Wearing compression garments

    • Gradually increasing exercise as tolerated

    • Antidiuretics (Desmopressin acetate)

    • Beta Blockers (Propranolol)

    • Centrally acting sympatholytic drugs (Clonidine)

    • Cholinesterase Inhibitors (Pyridostigmine Bromide)

    • Mineralocorticoids (Fludrocortisone)

    • Stimulants (Amphetamine, Dextroamphetamine, Methylphenidate)

    • Vasoconstrictors (Midodrine)

    IV fluids can also be helpful in treating POTS, however, it is a treatment option that can be hard to manage and is usually a treatment suggested after many unsuccessful less invasive treatment attempts.

  • https://www.standinguptopots.org/resources/medicine

    https://www.health.harvard.edu/blog/pots-diagnosing-and-treating-this-dizzying-syndrome-202110062611

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7046364/#:~:text=The%20prevalence%20of%20POTS%20is,United%20States%20have%20the%20disorder.

    https://my.clevelandclinic.org/health/diseases/16560-postural-orthostatic-tachycardia-syndrome-pots