Postural Orthostatic Tachycardia Syndrome (POTS)
What is POTS?
Postural orthostatic tachycardia syndrome affects blood flow. Those with POTS cannot coordinate blood vessel squeeze and heart rate response, which means they cannot keep a stable blood pressure. It affects the sympathetic nervous system and autonomic nervous system.
There are three types of POTS: neuropathic, which is caused by a loss of the nerve supply, hyperadrenergic, which is caused by an overactive sympathetic nervous system, and low blood volume, which is caused by a reduced blood volume.
Females from the ages of 13-50 are at a higher risk of developing POTS. It is estimated that about 450,000 people in the U.S. have this condition.
What are the symptoms of POTS?
Symptoms vary for each individual, and they can come and go over a long period of time. Possible symptoms include:
- High or low blood pressure
- High/low heart rate
- Chest pain
- Abdominal pain
- Temperature deregulation
- A nervous, jittery feeling
- Trouble focusing
- Blurred vision
- Head and body aches
- Discoloration of the feet and hands
- Exercise intolerance
- Excessive or a lack of sweating
What causes POTS?
The exact cause of this condition is not well understood. Major events have been known to set it off, such as pregnancy, trauma, major surgeries, or viral illness. Menstrual periods have also been known to cause episodes as well.
Researchers believe that more than one cause may lead to POTS. These causes include impaired function of the nerves in certain muscles, an abnormal decrease in blood volume, too little blood returning to the heart, changes in heart and blood vessel function, abnormal regulation of blood pressure, and an increased fight-or-flight response.
There is also some evidence to suggest that inheritance plays a role in this condition. Some people with POTS have a family history of orthostatic intolerance, suggesting genetics play a role.
How is POTS diagnosed?
A diagnosis is often difficult to obtain. The tilt table test, which measures blood pressure and heart rate as one changes posture and position, is the best way to diagnose this condition. Other tests that doctors may use are blood and urine tests, QSARTs, autonomic breathing tests, TST, skin nerve biopsies, echocardiograms, and blood volume with hemodynamic studies.
What are the treatments for POTS?
Medications like salt tablets, fludrocortisone, pyridostigmine, midodrine, and beta blockers are all options for the treatment of POTS. Medical compression stockings also help to move blood up from the legs. A blood pressure monitor is helpful as well. If the heart is not healthy, a cardiac rehab program might be a step that your doctor recommends.
There are also simple life changes that can help to manage the symptoms of POTS. These include diet, daily monitoring of blood pressure and heart rate, exercise, and maintaining a constant sleep schedule.