Postural Tachycardia Syndrome (POTS)
Download and print the POTS
information sheet
Over the years there has been a substantial increase in the understanding of illnesses that result from disturbances in the autonomic system.
Consultants are seeing patients with reflex syncope but are often finding that they are also presenting with postural tachycardia (a very fast heart rate that occurs after you stand up), severe fatigue and exercise intolerance.
These patients can be told they are suffering with POTS.
What is POTS?
Postural Tachycardia Syndrome (POTS) is a manifestation of autonomic dysfunction and is defined as an increase in heart rate of over 30 beats per minute when standing upright but without a postural fall in blood pressure; this is often made worse by even modest physical exertion. It is a relatively new disorder, which is slowly being recognized by the medical profession. It is often underappreciated by physicians, which can impact on the patient’s quality of life through misdiagnosis or being informed symptoms are “all in their head”. Historically, many patients with POTS were given a diagnosis of Chronic Fatigue Syndrome/ME, anxiety or panic disorder.
Some patients are so incapacitated by their symptoms that they are often misdiagnosed as having chronic anxiety or panic disorder or, worse being told that it is all "in their head".
SymptomsThe main symptoms of POTS include:
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Potentially related symptoms:
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Who suffers with POTS?
Most sufferers of POTS are between 15 and 50 years of age, but it can strike at any time. Research has shown that approximately five times more females are affected by POTS than males and, sadly, some sufferers wait a year before plucking up the courage to talk to their doctor ‚ afraid they will be thought to be making a fuss.
Developmental POTS affects adolescents. Often beginning around age 14 years, peaking at 16 years, then slowly fading in young adulthood. It can occur typically after the onset of puberty and sometimes following a period of rapid growth.
Patients can suddenly develop symptoms following a viral infection or severe shock.
Autonomic specialists believe that in some cases there may be an overlap between people with POTS and some individuals suffering with chronic fatigue syndrome.
To learn about real life stories and experiences of POTS from all ages click here.
What help is there?
Some sufferers become debilitated and find it impossible to continue working or struggle to attend school on a regular basis. This can cause depression and it is essential that they have the support and understanding of a doctor or a consultant who is familiar with the condition.
Medication:
Some specialists do prescribe medication and Midodrine is well known as a drug that can help sufferers lead a more normal life.
Self help:
- Drinking water can help patients with low blood pressure. (Read more)
- Elastic support stockings.
- Increasing salt intake (10 -20g of salt).
Therapy:
Cognitive Behaviour Therapy (CBT) has proved to be very successful in helping a patient come to terms with this often overwhelming condition and to help them manage their lives.
It needs to be recognised, however, that POTS can be very disabling for the patient and very stressful for their family. There is no one treatment for everyone and sometimes it is a case of trial and error. Patients should never lose hope‚ hope is a powerful medicine that should be nurtured.
POTS and Pregnancy
Patients with POTS can safely complete pregnancy. POTS should not be considered as a reason to not go through pregnancy. Blair Grubb discusses POTS and Pregnancy in:
- Outcomes of Pregnancy in Patients with Pre-existing Postural Tachycardia Syndrome
Khalil Kanjwal, Beverly Karabin, Yousef Kanjwal and Blair P.Grubb
The Autonomic Nervous System (ANS)
The Autonomic Nervous System controls everything we have to think about. Examples of this are heart rate, blood pressure, body temperature and breathing amongst other things.
Normally we can adjust to changes around us very quickly. However, a person whose ANS isn't working correctly does not respond normally. It may take them longer to adjust or they may do just the opposite of what is expected. This can also start a cycle of trying to re-adjust to a given situation ‚for example, the heart rate rises then drops, then rises again.
A simple explanation is that the heart and the brain are divorced and are refusing to speak to each other!
Julia Newton, A Newcastle Perspective on Postural Tachycardia Syndrome (POTS), download the article in PDF