Postural Orthostatic Tachycardia Syndrome (POTS)


Postural orthostatic tachycardia syndrome (POTS) is a disorder characterized by dizziness and rapid heartbeat in response to standing. With POTS, the heart rate increases dramatically with the position of the body.

Most people with POTS are women between the ages of 13 and 50. Some people have a family history of POTS, but most do not; Some people report that hormonal conjunction started after illness or stressor, others report that it started gradually.

The diagnosis is based on an evaluation of your blood pressure and heart rate (heart rate). The effects range in severity from relatively mild to disabling, and medications and lifestyle strategies can help reduce symptoms.

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POTS symptoms

POTS is a disease that can affect otherwise healthy young people. The condition can start suddenly. It usually occurs between the ages of 15 and 50, and women are more likely to develop it than men .

With POTS, you may experience a variety of symptoms that occur within minutes of getting up from a lying or sitting position. Symptoms can occur frequently, even daily.

The most common symptoms of POTS include :

  • Daze
  • Fast heartbeat (feeling like you have a fast or irregular heartbeat)
  • Legs turn reddish purple
  • Dizziness
  • Blurry vision
  • Soft spot
  • Tremble
  • Feeling anxious
  • Headache
  • Fatigue
  • Feeling like you almost passed out
  • Sleep disorders
  • Concentration problems

You can experience any combination of these symptoms with POTS.

If you have POTS, you may also experience intermittent bouts of fainting , usually without any additional factors other than standing up.

Sometimes people with POTS cannot tolerate sports or exercise and may feel dizzy and lightheaded in response to light or moderate physical activity. This can be described as exercise intolerance.

Related Effects

POTS can be associated with other dysautonomia syndromes such as neurocardiogenic syncope.

People with POTS are often diagnosed with other conditions, such as chronic fatigue syndrome, Ehlers-Danlos syndrome, fibromyalgia, migraine, and other autoimmune and / or intestinal conditions.


Usually, when you stand up, the blood runs to the legs. This sudden change means that the heart pumps less blood immediately.

To compensate for this, the autonomic nervous system tells the blood vessels to contract to push more blood to the heart and maintain normal blood pressure and heart rate. Most people do not experience significant changes in blood pressure or heart rate when standing.

However, sometimes the body can't do it right. If your blood pressure drops while standing and causes symptoms like dizziness, this is called orthostatic hypotension . If your blood pressure remains normal but your heart rate increases, it is called POTS.

The factors that cause POTS are likely to be different for each person, but they are associated with changes in the autonomic nervous system, adrenal hormone levels, total blood volume (which can decrease with dehydration), and poor exercise tolerance.

Autonomic nervous system

Blood pressure and heart rate are controlled by the autonomic nervous system, the part of the nervous system that controls internal body functions, such as digestion, breathing, and heart rate. When you are standing up, your blood pressure may drop slightly and your heart rate may speed up slightly. With POTS, these changes are more dramatic than usual.

POTS is considered a type of dysautonomia in which the regulation of the autonomic nervous system is reduced. There are several other syndromes that are also believed to be associated with dysautonomia, such as fibromyalgia , irritable bowel syndrome, and chronic fatigue syndrome.

It is not clear why hormonal syndrome or some other type of dysautonomia develops, and there appears to be a family predisposition to these conditions.

Sometimes the first episode of POTS occurs after a health event such as:

  • Acute infectious disease like severe flu.
  • An episode of trauma or concussion.
  • Extensive surgical intervention
  • The pregnancy


Your diagnostic evaluation will include your medical history, physical exam, and diagnostic tests. Your healthcare provider can measure your blood pressure and heart rate at least twice: once lying down and once standing up.

Usually standing up increases your heart rate by 10 beats per minute or less. When using POTS, the heart rate is expected to increase by 30 beats per minute or more, while the blood pressure will stay roughly the same.

In POTS, the heart rate remains elevated for more than a few seconds while standing (often 10 minutes or more), symptoms occur frequently, and the condition persists for more than a few days.

Position changes in impulse are not the only diagnostic implications for POTS, as you may experience this degree of change in other conditions.

Diagnostic tests

The table tilt test can be helpful in diagnosing POTS. During this test, your blood pressure and heart rate are measured at various intervals when you are lying on the table and when the table is placed in an upright position.

Differential diagnosis

There are many causes of dysautonomia , syncope , and orthostatic hypotension. During your physical exam, your healthcare provider may consider other conditions in addition to POTS, such as dehydration, poor air conditioning after prolonged bed rest, and diabetic neuropathy .

Medications such as diuretics or blood pressure medications can also cause effects similar to POTS.

Watch out

There are several important approaches used in the management of POTS, and you may need to combine several therapeutic approaches.

Your healthcare provider may recommend that you regularly check your blood pressure and pulse at home so that you can review the results when you go for your checkups.

Fluids and diet

Drinking decaffeinated fluids can help you stay hydrated. You and your healthcare professional can estimate how much fluid you need each day. Nocturnal dehydration is common, so it's especially important to drink fluids in the morning (before getting out of bed, if possible).

It is also important to maintain an adequate intake of sodium. In general, it is very rare for a person to have very little sodium, but this is a factor to consider.


Physical therapy can help your body learn to stand tall. Because it can be very difficult for you to exercise when you have POTS, a formal supervised exercise program may be required.

A potty exercise program can begin with swimming or using rowing machines that do not require an upright posture. Usually after a month or two, walking, running, or biking can be added.

If you have POTS, you will need to continue the exercise program for a long time to prevent symptoms from coming back.


Prescriptions that have been used to treat POTS include midodrine, beta- blockers , pyridostigmine (mestinone), and fludrocortisone.

Ivabradine , used for a heart condition called sinus tachycardia, has also been used effectively in some people with BURNING SEASONS.

Compression socks

Your healthcare provider may prescribe compression stockings to prevent too much blood from getting into your legs when you're standing, which can help you avoid orthostatic hypotension.

Get the word of drug information

POTS is a condition that can be very destructive and frustrating. This condition often affects the young, and although it often resolves over time, treatment is helpful.

You may need to make some adjustments to your medications while you and your healthcare provider work to find the correct medication and dosage for you.

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