What is Postural Orthostatic Tachycardia Syndrome (POTS)?
Postural orthostatic tachycardia syndrome (POTS) is a disorder that affects blood circulation. It’s a common form of dysautonomia that affects millions of people. Typically, the blood flows at a steady pace even when a person moves around. However, if the pace of blood flow slows down when a person makes a sudden movement (like sitting up or standing up), that person may have a condition called orthostatic intolerance (OI). OI coupled with an increased heart rate indicates that the person has POTS. When a person with this condition stands up, most of the blood remains in the lower part of the body and the heart rate increases in an attempt to pump blood to the blood. While this is happening, the person’s blood pressure typically drops. While all of this is commonly experienced by those with this condition, the presence of other symptoms may present themselves differently per person.
Those with postural orthostatic tachycardia syndrome (POTS) suffer from dizzy spells and may even faint if they change positions abruptly. This may occur when the person stands suddenly after being in a seated position or when they sit up after laying down. These symptoms can impede on people’s ability to successfully focus on work tasks, especially if the job requires them to be on their feet a lot or even move in and out of a seated position. For this reason, those with POTS may be able to establish that they are disabled from this condition alone or, most commonly, as part of a syndrome of cardiovascular impairments and symptoms.
Symptoms of POTS
Aside from the lightheadedness, fainting, increased heart rate, and decreased blood pressure, other symptoms that people may experience include:
- Chronic fatigue
- Chest pain
- Nausea
- Sweatiness
- Heart palpitations
- Shortness of breath
- Anxiety
- Difficulty sleeping
- Difficulty concentrating
- Tremors or shaking
- Weakness
The severity of these symptoms will vary on the person. They can be mild or extremely debilitating.
Types of POTS
The cause of POTS isn’t isolated to one factor. Some people may come to learn that they have several factors that have led to their condition. These factors can lead to different types of POTS. These can include:
- Neuropathic POTS: This type is characterized by damaged nerves. Specifically, the nerves that are responsible for the constriction of blood vessels in the abdomen and limbs.
- Hyperadrenergic POTS: This type is characterized by high levels of norepinephrine, which is a stress hormone.
- Hypovolemic POTS: This type is characterized by extremely low blood volume.
- Secondary POTS: This type is characterized by other conditions that cause autonomic neuropathy. These other conditions can include diabetes, lupus, or other autoimmune diseases.
Getting a proper diagnosis of this condition can be difficult. A tilt-table test is one common way doctors may try to diagnose this condition. This test requires the patient to be strapped to a table while a doctor tilts it various ways to create the symptoms of POTS. Doctors believe that if the patient’s heart rate increases by 30 or more beats per minute (bpm) or goes over 120 bpm within ten minutes of the sudden movement, the patient is likely to have POTS. Other tests may be performed to confirm that the patient has POTS and not another type of dysautonomia. These tests include an electorcardiogram (ECG) or an active standing test.
Treatments for POTS
Treatment for this condition should vary based on the individual and the severity of their symptoms. Unfortunately, there isn’t a cure. Doctors focus on treating the POTS symptoms rather than treating the actual condition. Some of these treatments include medication like beta blockers, midodrine, fludrocortisone, pyridostigmine, or even salt tablets. Doctors may even suggest wearing medical compression socks to encourage the blood to flow up the legs. Keeping fluids in the body to increase the amount of blood the body produces is also important, so doctors may encourage people to take on a diet high in salt and drink a lot of water. Walking or doing yoga can help the blood flow and maintain a healthy heart, so this may be something a person should consider if they don’t already exercise lightly. If a person’s symptoms are severe, doctors may suggest changing their lifestyle completely and this may include the type of work they perform. For example, if a person with POTS works as a server, a doctor may suggest that the person take on a job that requires less exertion. Unfortunately, this often means that people have a hard time finding work again. Luckily, those in this situation have an opportunity to get financial assistance.
