Postural orthostatic tachycardia syndrome (POTS) is a condition that affects the autonomic nervous system, which controls blood pressure, heart rate, and body temperature. It causes your heart rate to increase quickly when you move from sitting or lying down to standing up position, and your blood pressure to fall.
Normally your autonomic nervous system is functioning properly, it keeps blood flowing around your body at a healthy pace, regardless of how you move.
When we sit or lie down, blood pools in the lower half of your body, causing a natural drop in blood pressure. If you have POTS, your nervous system won’t automatically respond when you stand up. To compensate, your heart rate increases, trying to pump blood to the upper half of your body.
You may only experience mild symptoms from POTS, or you might find that the condition seriously impacts your quality of life and ability to complete everyday tasks.
Postural: related to position of your body
Orthostatic: related to standing upright
Tachycardia: rapid heart rate
Syndrome: Multitude of symptoms
Common
Dizziness
Fainting
Brain fog
Palpitations and racing of heart
Exhaustion
Fatigue
Feeling anxious of nervous
Less common symptoms:
Headaches
Disturbed sleep
Irritable Bowel syndrome
Shakiness or excessive sweating
Forgetfullness and trouble focusing
There are several reasons why your symptoms may appear worse at certain times. These include:
If you’re standing for a long time
Not eating enough or drinking enough fluids
An increase in body temperature, such as after a hot bath or shower, or after spending time outside on a hot day
Taking part in strenuous exercise
Feeling unwell from a cold or an infection
POTS symptoms often get worse in the following situations:
Being in warm environment such as in a hot bath or shower or on a hot day
Standing frequently, such as when you are waiting in line or shopping
Participating in strenuous exercise
When you are sick such as from a cold or an infection
Who does POTS effect?
Significant illnesses such as viral illness like mononucleosis or serious infections
Physical trauma such as head injury
Pregnancy
Surgery
Following tests may be required to diagnose POTS:
12 Lead Electrocardiogram
Ambulatory Heart Monitor
Transthoracic Echocardiogram
Tilt Table Testing
Blood and urine tests to exclude certain conditions
Unfortunately, there is no cure for POTS. There are several strategies and life style changes to manage the symptoms.
Treatment is individualised based on your symptoms and what best works for you.
Non-Drug measures:
- Medical compression stockings can also help push blood up from your legs to reduce POTS symptoms
- Aerobic exercise, such as swimming, rowing and recumbent bicycling, has the best results. Strengthening your core and leg muscles is also helpful. Walking exercise is also very helpful.
- Adequate fluid intake 2-2.5 liters per day. Water is the best choice
- Increase sodium in your diet (salt) from 3000 milligrams to 10,000 mg per day
- Eating small and frequent meals instead of few large meals
- Eating a diet with high fiber and complex carbohydrates may help reduce glucose (sugar) spikes and lessen POTS symptoms.
- Avoid prolonged standing
- Avoid excessive alcohol
Medication
- Beta-blockers
- Fludrocortisone
- Midodrine
Learning that you have postural orthostatic tachycardia syndrome (POTS) can be overwhelming. Knowing that there are several treatments and lifestyle adaptations can help manage your symptoms. No two people with POTS are affected in the same way, so it’s important to receive individualized care that’s unique to your situation.
If you’re worried you may have symptoms of POTS, we can help by arranging a consultation with a cardiologist and any tests required.
