Postural Orthostatic Tachycardia Syndrome (POTS): Symptoms, Causes, and How It’s Treated

If you’ve ever stood up and experienced a rush of exhaustion, a racing heart, and a spinning head, you’re undoubtedly asking what’s wrong and what’s causing it. These symptoms are a daily struggle for some people, not just a passing dizziness episode.

Postural Orthostatic Tachycardia Syndrome (POTS) also affects the autonomic nervous system. It is typified by an unusual rise in heart rate when a person moves from a supine to a standing position. According to research, women between the ages of 13 and 50 make up as much as 80–85% of those with POTS.

A simple task like getting out of bed can feel like climbing a mountain when someone has POTS. However, there is hope. This article will cover the definition of POTS, symptoms, diagnostic tests, and therapeutic methods to help control symptoms and improve quality of life.

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What Is Postural Orthostatic Tachycardia Syndrome (POTS)?

Reduced adequate circulatory volume and increased sympathetic nervous system activity are the hallmarks of postural orthostatic tachycardia syndrome (POTS), which result in a variety of uncomfortable autonomic symptoms. Experts regard it as a syndrome rather than a singular disease because numerous possible causes exist.

Standing up straight is the most prevalent way for patients with POTS to experience their symptoms. When standing, patients struggle to control their heart rate and blood flow. Reduced cerebral perfusion, or blood flow to the brain, and an inflated sympathetic nervous system “fight or flight” response are two possible outcomes of this.

The following definitions apply to each word in “postural orthostatic tachycardia syndrome”:

• Postural: Your body’s position influences it.
• Orthostatic: Associated with erect posture.
• Tachycardia: A heart rate exceeding 100 beats per minute.
• Syndrome: A collection of related symptoms.

Normally, your autonomic nervous system regulates blood pressure and heart rate to ensure steady circulation, regardless of posture. In POTS, however, the body struggles to coordinate heart rate adjustments with blood vessel constriction, disrupting this balance. It indicates that your body is unable to maintain consistent and stable blood pressure. Many symptoms result from this.

POTS Symptoms

POTS may develop abruptly or progress slowly over time. After standing or sitting up, symptoms may appear right away or a few minutes later. Some symptoms may improve when you lie down. The symptoms include:

• Extreme and/or persistent exhaustion.
• Prolonged standing or sitting may lead to dizziness and result in fainting.
• Brain fog is the inability to concentrate, recall, or pay attention.
• Palpitations, or the sensation that the heart is hammering or skipping a beat, or forceful heartbeats.
• Vomiting and nausea.
• Headaches
• Excessive perspiration.
• Shakiness
• Exercise intolerance or a protracted deterioration of overall symptoms following an increase in activity.
• Chest pain, a fast heartbeat, and profuse perspiration during sleep that interfered with sleep.

The cause of POTS is unknown, but experts are learning more about the condition, says Dr. Alison Bailey, cardiologist and national physician director for cardiac disease at HCA Healthcare, our larger network.

“In general, POTS is a dysregulation of the autonomic system,” Bailey says. “Your brain, heart, and blood vessels need to function in sync to keep you from getting dizzy when you make position changes or exercise. But with POTS, there’s some abnormality in that cycle that prevents this from occurring.”

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What Causes POTS?

Each person has a different cause of POTS. The exact causes of this condition are not yet fully understood by researchers. Although there is disagreement about how to categorize POTS, the majority of authorities acknowledge that it has various features that affect some individuals more than others. Crucially, a person with POTS may have multiple of these traits at the same time; they are not mutually exclusive:

• Neuropathic POTS: This condition arises when peripheral denervation (loss of nerve supply) weakens the muscles of the blood vessels, especially in the legs and abdominal area.
• Hyperadrenergic POTS: In hyperadrenergic POTS, the sympathetic nervous system becomes excessively active.
• Hypovolemic POTS: POTS may result from a decrease in blood volume. Reduction in our blood volume may trigger symptoms that resemble and overlap with both the neuropathic and the hyperadrenergic POTS.
• Secondary POTS: Secondary POTS is described the cases connected to another underlying condition, like diabetes, Lyme disease, or an autoimmune disorder such as lupus or Sjögren’s syndrome, which may also cause autonomic neuropathy.

How POTS is Diagnosed

Diagnosing POTS can sometimes feel like putting together the pieces of a puzzle. Although many individuals see several doctors before receiving a diagnosis, a diagnosis is achievable with the correct tests and a physician who is attentive to your symptoms.

“Patients and physicians can confuse the symptoms of POTS with a number of medical conditions. In addition, POTS can often be incorrectly attributed to anxiety and other behavioral conditions. As a result, it’s important to perform an appropriate medical evaluation,” says Dr. Steven Manoukian, cardiologist and HCA Healthcare senior vice president and fellow of the American Heart Association. “Only after a thorough assessment of a patient’s symptoms can an accurate diagnosis be made.”

A healthcare professional will ask about your symptoms, prescriptions, and medical history. They will also do a physical examination.

The primary method used by doctors to detect POTS is a tilt table test. As you shift positions and postures, the tilt table test records your blood pressure and pulse rate.

A doctor may measure your heart rate and blood pressure both before and after you get up if you have signs of post-traumatic stress disorder. If PoTS is suspected, additional tests may be carried out, such as:

• Blood examinations
• Urine examination
• Testing for the heart and blood pressure, such as an ECG, echocardiography, and 24-hour monitoring of heart rate and blood pressure
• Skin nerve biopsy

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How POTS Is Treated

Although POTS cannot be cured, several therapies can significantly enhance quality of life. Doctors usually use a variety of strategies in treatment, such as compression clothing, increased salt and fluid consumption, and progressive exercise regimens. Medication may be necessary for certain people to control their intravascular volume and heart rate.

Doctors frequently treat POTS with supportive therapy, lifestyle modifications, and occasionally medication. Here is further information about these methods:

Lifestyle Changes:

• Steer clear of Alcohol and Caffeine: Since alcohol and stimulants like coffee can disrupt fluid balance and exacerbate symptoms of dizziness, jitters, and instability, limiting their use can help manage symptoms.
• Compression Clothing: You can promote circulation and reduce blood pooling in your legs by wearing compression socks or abdominal binders. These are pricey and simple to locate online. You can choose one by asking your provider for advice.
• Head Elevation: To help increase blood flow, try raising the head of the bed by four to six inches on blocks when you’re lying down to sleep.

Drugs for the Syndrome of Postural Orthostatic Tachycardia:

Although there are no FDA-approved drugs especially for POTS, your doctor may suggest the following medicines to assist in controlling blood pressure and heart rate:

• Beta-blockers: To lessen palpitations and calm the heart rate.
• Midodrine: The vasoconstrictor can prevent blood from pooling in your lower extremities.
• Ivabradine reduces heart rate without affecting blood pressure.

Other Supportive Treatments:

• Exercise: By performing specific exercises, you may gradually improve your standing and walking abilities.

Living with POTS: Coping and Support

It can be tough to live with Postural Orthostatic Tachycardia Syndrome (POTS). Implementing appropriate coping mechanisms and relying on support networks can make everyday life much easier.

Meditation and Mindfulness: These techniques can aid in lowering stress and anxiety. By encouraging people to remain composed and in the moment, these kinds of strategies help people to control their emotional reactions to POTS’s unpredictability.

Creating a Support System: Getting in touch with people who have experienced what it’s like to live with POTS will help you feel less alone. Family, friends, support groups, and online communities can all offer a sense of community and emotional support.

Professional Counseling: It can be pretty beneficial to seek therapy from a mental health specialist who is knowledgeable in chronic illness. By assisting patients in reframing their pessimistic views, cognitive behavioral therapy, or CBT, is especially successful in treating the anxiety and despair linked to POTS.

When to See a Specialist

See a healthcare professional if standing up results in odd symptoms like dizziness and a racing heartbeat.

To receive the most excellent care if you have POTS, attempt to see a medical professional who specializes in the condition. To manage your health and wellness and receive routine care, you will also require a primary care physician.

In addition to helping patients receive individualized treatment, lifestyle advice, and long-term support for properly managing POTS, early expert participation enhances symptom control.

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Final Thoughts

A severe ailment that is frequently misdiagnosed or disregarded, Postural Orthostatic Tachycardia Syndrome (POTS) can have a significant impact on day-to-day functioning and general quality of life. The accompanying weariness, dizziness, and fast heartbeat are not “just in someone’s head”; instead, they are the consequence of actual autonomic nervous system dysfunction.

The good news is that many people can improve their everyday functioning, regain their independence, and lessen their symptoms with the correct treatment and management techniques. Changing one’s lifestyle, monitoring symptoms, and receiving medical care can all help manage POTS.