POTS - World Day! Postural Orthostatic Tachycardia Syndrome

October 25th is World Postural Orthostatic Tachycardia Syndrome Day!

Find out more!

What is POTS?

Postural Orthostatic Tachycardia Syndrome (POTS) is a form of dysautonomia, a disorder affecting the autonomic nervous system, which controls bodily functions like heart rate, blood pressure, digestion, and temperature regulation. In POTS, the key issue is an abnormal increase in heart rate when transitioning from lying down to standing up, without a significant drop in blood pressure. This condition can lead to a variety of symptoms that affect daily life and vary in severity.

POTS is often diagnosed based on a heart rate increase of at least 30 beats per minute (bpm) in adults (or 40 bpm in adolescents) within 10 minutes of standing, without a corresponding drop in blood pressure.

Common Symptoms of POTS

POTS can produce a range of symptoms, including:

1. Rapid heart rate (tachycardia) upon standing.

2. Dizziness or feeling lightheaded, especially when standing up.

3. Fainting (syncope) or feeling close to fainting.

4. Fatigue, often severe and persistent.

5. Brain fog, including difficulty concentrating or thinking clearly.

6. Chest pain or palpitations.

7. Shortness of breath, especially when standing.

8. Headaches and migraines.

9. Nausea or gastrointestinal problems, including bloating and diarrhea.

10. Cold hands and feet, or changes in skin color (e.g., a purplish discoloration of the legs when standing).

11. Exercise intolerance—feeling unwell after even mild physical exertion.

Key Questions and Answers

1. How is POTS diagnosed?

POTS is diagnosed using a tilt table test or by measuring heart rate and blood pressure changes during a simple standing test. In the tilt table test, a person is strapped to a table that tilts them from a lying to standing position while monitoring heart rate and blood pressure. A heart rate increase of 30 bpm (or 40 bpm in adolescents) within 10 minutes of standing without a significant drop in blood pressure indicates POTS.

2. What causes POTS?

POTS has multiple potential causes, including:

• Genetics: Some people have a genetic predisposition to POTS.

• Viral infections: Many cases begin after a viral illness (e.g., mononucleosis, COVID-19).

• Autoimmune disorders: POTS can co-occur with autoimmune diseases like lupus or Sjögren’s syndrome.

• Deconditioning: A long period of bed rest or inactivity may trigger POTS symptoms.

• Ehlers-Danlos Syndrome (EDS): Many people with POTS have hypermobility syndromes like EDS.

3. How is POTS treated?

While there is no cure for POTS, treatment focuses on managing symptoms. Common approaches include:

• Increased fluid and salt intake: to help raise blood volume.

• Compression stockings: to improve circulation in the legs.

• Exercise regimen: gradual reconditioning with exercises like recumbent biking.

• Medications: Beta-blockers, fludrocortisone, midodrine, and others may help control heart rate and blood pressure.

4. Is POTS related to long COVID?

Yes, some people develop POTS after recovering from COVID-19, and it is a recognized manifestation of long COVID. The virus is believed to affect the autonomic nervous system, leading to the development of POTS symptoms in previously healthy individuals.

5. Can POTS improve or resolve over time?

Some people experience significant improvement or even remission of symptoms over time, especially with appropriate treatment and lifestyle changes. However, POTS can also be a chronic condition, and for some, it may require long-term management.

Citations & Further Reading

7 Cups Interview - Living with hEDs and POTS
7 Cups Post - Drop with Pots

7 Cups Interview - POTS and Me

POTS World Day Information

1. National Institute of Neurological Disorders and Stroke (NINDS) - POTS Overview

• NINDS POTS Fact Sheet

Johns Hopkins Medicine - POTS Diagnosis and Management

• Johns Hopkins on POTS

Mayo Clinic - Overview of POTS

• Mayo Clinic POTS Overview

  
  

  Written as part of the Disability Support Community Articles. More can be found 
  If you have a condition or 'Awareness Campaign' that you feel we should recognise please message  @MistyMagic (teens and adults) or @AffyAvo (adults)