What Is POTS

POTS or Postural orthostatic tachycardia syndrome is a form of dysautonomia. It is an abnormal response to becoming upright. There is a high increase in heart rate and altered blood supply to the brain on standing also occurs. This results in a large number of symptoms. The most common ones are dizziness, fainting, extreme fatigue and palpitations.

But wait, what is dysautonomia?

Dysautonomia is when the autonomic nervous system isn’t working correctly. This controls things we don’t have to think about doing they just happen automatically. Including:

Heart rate and blood pressure

Digestion

Bladder control

Sweating

Stress response

So what causes this?

Many of the cases, the cause go unknown. Some develop symptoms in their teenage years during a period of rapid growth and see a gradual improvement in their mid twenties. Others develop POTS after having a bacterial infection or a trauma such a car accident or injury. Women can develop POTS during or after pregnancy. There are also reports showing it could be genetics from family having an orthostatic intolerance. Between 75-80% patients are female.

When you have POTS and stand up what happens?

When lying down 25% of our blood lies in out chest cavity, under normal circumstances when we stand, up to 800 milimtres of blood will be pulled down by gravity from our chest to the abdomen and legs. To maintain the blood supply to our brain the sympathetic nervous system will react immediately narrowing blood vessels. Heart rate increases by 10-15 beats per minutes and there is a very slight increase in blood pressure. People with pots these mechanisms fail altering the blood to the heart and brain. Within 10 minutes of standing up, paitents experience an increase in heart rate of at least 30 bpm or more; there is also often significant drop in blood pressure. Your blood pressure can raise when you stand if you have HyperPOTS. 

What are the symptoms of having POTS?

Symptoms can fluctuate from day to day and can include:

Dizziness

Light-headedness

Pre-snycope( Almost fainting)

Syncope( fainting or black outs)

Extreme fatigue

Weakness

Brain fog- difficulty concentrating and thinking

Memory Loss

Shaking

Shortness of breath

Chest Pain

Excessive or reduced sweating

Nausea

Vomiting

Bloating

Insomnia

Headaches

Visual problems

Confusion

Disorentation

Weight gain

Excersize intolerance

Muscle weakness

Abdominal pain

Depression

Decreased mental stamina

Chills

Overheating

Nervousness

Excessive thirst

Anxiety

The list can go on and on these are just a few of the everyday symptoms I live with.

People with POTS can develop conditions associated with POTS, these can include:

Chronic fatigue syndrome

Ehlers-Danlos syndrome

Irritable bowel syndrome

Restless leg syndrome

Vasovagal syncope

Small fiber peripheral neuropathy

How is it Diagnosed?

POTS can be difficult to diagnose, a tilt table test is vital to diagnosing POTS, although all symptoms must be considered before a final diagnosis is made.

How do you treat POTS?

There is no known cure for POTS at this time but there are some treatments to help symptoms. Lifestyle changes such as increasing fluid intake, salt intake and doing small exercises are shown to help. Avoiding situations of standing of standing still, and heat are necessary.

Medications are also used to treat symptoms.

Compression stockings can help reduce symptoms

Avoiding alcohol, eating small frequent meals, and switching diet can also help.