Postural orthostatic tachycardia syndrome (POTS) is a condition that affects circulation/blood flow. For a healthy individual, their heart rate and blood pressure work together to keep the blood flowing at a healthy and steady pace, regardless of what position their body is in (eg. standing, sitting, laying down, hanging upside-down, etc.). Individuals with POTS cannot coordinate the balancing act of blood vessel squeeze and heart rate response, leading to an unstable blood pressure. When a change of body position results in a change in blood flow rate, it indicates an Orthostatic Intolerance (OI). POTS is a disorder that has OI as its most common symptom. Therefore, if a patient with POTS stands up after lying down, they will likely experience lightheadedness, dizziness/fainting, and a rapid heart rate. This occurs because a majority of the patients’ blood remains in the lower part of their body, even when they stand up. In turn, the heart begins beating faster to try and get blood to the brain, which can cause a drop in blood pressure. Each case of POTS is unique, but when handled correctly, it can lead to improvement in quality of life. Specifically, if the underlying cause if found and treated, POTS symptoms may diminish. However, if POTS is caused by an incurable disease, such as EDS, symptoms will have to continue to be managed and watched.
Quick Facts
Prevalence: Common, more than 200,000 U.S. cases per year. It can affect anyone at any age but most commonly affects women between the ages of 15-50.
Possible Causes:
Ehlers-Danlos Syndrome
Anemia
Chronic Fatigue Syndrome
Diabetes
Viral illness
Serious infections (such as, mononucleosis, Lyme Disease, Hepatitis C)
Medical illness
Pregnancy
Trauma
Certain autoimmune conditions (Sjogren’s Syndrome, Cliac Disease, Lupus)
Symptoms:
High/low blood pressure
High/low heart rate (rapid heart rate)
Chest pain
Dizziness/lightheadedness, especially when standing up, standing in the same position, or long walks
Fainting or near-fainting
Exhaustion/fatigue
Abdominal pain, bloating, and nausea
Temperature deregulation
Nervous, shaking, or jittery feeling
Forgetfulness and trouble focusing (brain fog)
Blurred vison
Headaches (migraine) and body pain/aches
Chronic pain
Insomnia and frequent awakening from sleep, chest pain and racing heart during sleep, night sweats
Discoloration of feet and hands, red/bluish legs when standing
Exercise intolerance
Sweating abnormalities
Diarrhea and/or constipation
Areas Affected:
Autonomic nervous system: Automatically controls and regulates vital bodily functions such as heart rate, blood pressure, and breathing
Sympathetic nervous system: Activates the fight or flight response
Severity: Range from bothersome symptoms to debilitating
Diagnosis: POTS can be difficult to diagnose due to the amount and variety of symptoms. Patients symptoms often lead them to reach out to several different types of doctors and patients often have symptoms for months to year before receiving a diagnosis. A tilt table test, a test measuring your heat rate and blood pressure as you change positions, is a standard for a POTS diagnosis.
Treatment: There is no cure, but symptoms can be managed through medication, diet, and lifestyle changes.
Treatment: Medications and/or medical compression stockings
Lifestyle: Increase sodium to diet, drink a lot of water, small and frequent meals, diet with high fiber and complex carbohydrates, try to maintain a regular sleep schedule, and exercise
Timeline: Chronic, can last for years or be lifelong. Symptoms can also be on and off and fluctuate at different points in your life.
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