Postural Tachycardia Syndrome (POTS)

Overview

• Postural Tachycardia Syndrome (POTS) is a disorder of the autonomic nervous system.
• Affects bodily functions like heart rate, blood pressure, respiration, and digestion.
• Individuals with POTS experience orthostatic intolerance, primarily symptoms when in an upright position.

Pathophysiology

• In a healthy person, standing up triggers blood vessels to contract and a slight increase in heart rate to maintain blood supply.
• In POTS, this automatic adjustment fails, leading to excessive heart rate increase and altered blood flow to the brain.

Symptoms

• Palpitations
• Dizziness or lightheadedness
• Fainting or blackouts (Syncope)
• Chest pain
• Shortness of breath
• Shakiness or tremulousness
• Excessive sweating
• Gut and bladder problems
• Visual disturbances
• Fatigue and weakness
• Brain fog
• Headaches
• Feeling unwell after exercise
• Poor sleep
• Note: Not all individuals experience all symptoms; severity varies.

Impact

• POTS can be debilitating and significantly affect quality of life.
• Symptoms can vary day-to-day and are often worse in the morning.
• Some individuals manage symptoms well, while others may require wheelchairs or become housebound.

Associated Conditions

• Hypermobile Ehlers-Danlos Syndrome
• Allergies
• Long COVID
• ME/CFS (Myalgic Encephalomyelitis/Chronic Fatigue Syndrome)
• These conditions can exacerbate POTS symptoms.

Diagnosis

• Diagnosis can take years due to lack of awareness and specialists.
• Misdiagnosis as anxiety is common, but POTS is not a mental health condition.
• Correct diagnosis enables treatment options to improve symptoms and quality of life.

Management and Treatment

• High fluid intake and salt
• Small, frequent meals low in refined carbohydrates
• Compression clothing (though difficult to apply)
• Avoiding prolonged standing or sitting
• Exercise: challenging due to post-exercise malaise
• Medications are available but may be hard to obtain without specialists.

Additional Considerations

• More common in younger women, but can affect men, women, and children of all ages.
• Emotional and mental health support can be beneficial for managing long-term illness.
• POTS is a life-altering condition; visibility of symptoms does not always reflect severity.

Resources

• For more information, diagnosis processes, management techniques, or to make a donation, visit www.ps.org.