Postural orthostatic tachycardia syndrome

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Postural orthostatic tachycardia syndrome (POTS, also called postural tachycardia syndrome) is a medical problem. When a person has POTS, their heart beats faster than normal when they stand up. POTS may also cause many other symptoms.[1]

Meaning[change | change source]

  • Postural means that POTS symptoms depend on a person's posture (their position - for example, whether they are lying down or standing up)
  • Orthostatic means that a person is standing up
  • Tachycardia means that a person's heart is beating faster than normal
  • A syndrome is a group of symptoms

Put together, the words "postural orthostatic tachycardia syndrome" mean that when a person stands up, they get tachycardia, and they also have other symptoms.

Signs and symptoms[change | change source]

When a healthy person stands up, their heart beats faster for a little while. It does this to push blood to the brain. Then the person's heart rate goes back to normal.

When a person with POTS stands up, their heart beats much faster than normal. POTS is diagnosed when a person's heart rate increases by at least 30 beats per minute within 10 minutes after they stand up. This is called postural tachycardia.[1]

People with POTS also have other symptoms of orthostatic intolerance (symptoms that get worse when a person is standing up, and get better when the person is lying down).[1] These symptoms may include:[1] [2]

  • Palpitations (feeling the heart pounding)
  • Feeling dizzy, fainting, or almost fainting
  • Chest pain
  • Trouble breathing, especially when exercising
  • Feeling very weak or tired
  • Blurred vision (not being able to see clearly)
  • Headache
  • Trouble concentrating or thinking
  • Nausea
  • Trouble sleeping
  • Pallor (pale skin) or sweating

Symptoms may get worse if a person with POTS:

  • Sits for a long time[3]
  • Stands for a long time[3]
  • Drinks alcohol or caffeine[4][5]
  • Gets too hot[6]
  • Exercises too much[5]
  • Eats a large meal[3]

Causes[change | change source]

POTS can be caused by many different things.[1] Many of these causes are not well understood.

Some of the known causes of POTS include:

  • Genetics[7]
  • Recently being sick with a virus[2]
  • Chronic diabetes[8]
  • Hypovolemia (not having enough blood in the body).[1] This causes less blood to get to the heart. The body tries to fix this by making the heart beat faster, so more blood will get pushed into the heart.[7]
  • Problems with the nerves in the lower legs. This causes blood to pool in the lower legs. The body tries to fix this by making the heart beat faster so it can push more blood to the rest of the body.[9][2]

POTS is more common in:

Treatment[change | change source]

A woman riding a recumbent bicycle. Because it allows people to lie back while exercising, recumbent bicycling is often suggested for people with POTS

There are many different treatments for the symptoms of POTS.[5] Some of these treatments include:

  • Drinking a lot of water (this increases the amount of fluid in the body, which helps blood get to the heart more easily)[6]
  • Eating a high-salt diet (this helps keep fluid in the body and helps people with POTS from getting dehydrated)[5]
  • Getting exercise, especially exercise like recumbent bicycling (bicycling while lying back, which prevents symptoms caused by being upright)[12][5]
  • Using compression stockings (very tight socks) to keep blood from pooling in the legs[5]
  • Avoiding things that can make POTS worse, like getting dehydrated, exercising too much, eating large meals, drinking alcohol, or getting too hot[5]

No medications have been approved by the United States Food and Drug Administration to treat POTS.[6] However, sometimes doctors treat POTS with medications that:[5]

  • Prevent the body from losing salt;
  • Raise blood pressure; and/or
  • Keep the heart from pumping too fast.

Recovery[change | change source]

Most people with POTS are able to get better with treatment. About 6 out of every 10 people with POTS is able to recover within 5 years of being diagnosed with POTS.[5] About 9 out of every 10 people with POTS have some improvement with a combination of physical treatments and medicines.[8]

However, some people with POTS do not get better, and may even get worse over time.[8]

Related pages[change | change source]

Other websites[change | change source]

References[change | change source]

  1. 1.0 1.1 1.2 1.3 1.4 1.5 Mar PL, Raj SR (2014). "Neuronal and hormonal perturbations in postural tachycardia syndrome". Front Physiol 5: 220. doi:10.3389/fphys.2014.00220. PMC 4059278. PMID 24982638. 
  2. 2.0 2.1 2.2 Benarroch, E. E. (2012). "Postural tachycardia syndrome: a heterogeneous and multifactorial disorder". Mayo Clinic Proceedings 87 (12): 1214–1225. doi:10.1016/j.mayocp.2012.08.013. 
  3. 3.0 3.1 3.2 "Postural Orthostatic Tachycardia Syndrome". Dysautonomia International. Retrieved September 12, 2016.
  4. 4.0 4.1 Freeman, R., Wieling, W., Axelrod, F. B. (2011). "Consensus statement on the definition of orthostatic hypotension, neurally mediated syncope and the postural tachycardia syndrome". Clinical Autonomic Research 21 (2): 69–72. doi:10.1007/s10286-011-0119-5. 
  5. 5.0 5.1 5.2 5.3 5.4 5.5 5.6 5.7 5.8 Mathias, C. J., Low, D. A., Iodice, V., Owens, A. P., Kirbis, M., & Grahame, R. (2012). "Postural tachycardia syndrome—current experience and concepts". Nature Reviews Neurology 8 (1): 22–34. doi:10.1038/nrneurol.2011.187. 
  6. 6.0 6.1 6.2 Raj SR (2013). "Postural tachycardia syndrome (POTS)". Circulation 127 (23): 2336–2342. doi:10.1161/CIRCULATIONAHA.112.144501. PMC 3756553. PMID 23753844. http://circ.ahajournals.org/content/127/23/2336.full. 
  7. 7.0 7.1 Johnson, J. N., Mack, K. J., Kuntz, N. L., Brands, C. K., Porter, C. J., & Fischer, P. R. (2010). "Postural orthostatic tachycardia syndrome: a clinical review". Pediatric Neurology 42 (2): 77–78. doi:10.1016/j.pediatrneurol.2009.07.002. 
  8. 8.0 8.1 8.2 8.3 Grubb BP (2008). "Postural Tachycardia Syndrome". Circulation 117: 2814–17. doi:10.1161/CIRCULATIONAHA.107.761643. PMID 18506020. http://circ.ahajournals.org/content/117/21/2814.full. 
  9. Kavi L, Gammage MD, Grubb BP, Karabin BL (2012). "Postural tachycardia syndrome: multiple symptoms, but easily missed". British Journal of General Practice 62 (599): 286–87. doi:10.3399/bjgp12X648963. PMC 3361090. PMID 22687203. 
  10. Low, P. A., Sandroni, P., Joyner, M., & Shen, W. K. (2009). "Postural tachycardia syndrome (POTS)". Journal of Cardiovascular Electrophysiology 20 (3): 352–58. doi:10.1111/j.1540-8167.2008.01407.x. PMC 3904426. PMID 19207771. 
  11. "NINDS Postural Tachycardia Syndrome Information Page". National Institute of Neurological Disorders and Stroke. National Institutes of Health. December 2, 2015. Retrieved September 11, 2016.
  12. Grubb BP, Kanjwal Y, Kosinski DJ (2006). "The Postural Tachycardia Syndrome: A Concise Guide to Diagnosis and Management". Journal of Cardiovascular Electrophysiology 17 (1): 108–112. doi:10.1111/j.1540-8167.2005.00318.x.