Postural Orthostatic Tachycardia Syndrome: Symptoms, Diagnosis & Management

Feeling lightheaded, fatigued, or experiencing a rapid heartbeat upon standing?

These can be signs of postural orthostatic tachycardia syndrome (POTS). A complex disorder affecting the autonomic nervous system.

POTS disease can make everyday activities difficult, leading to chronic discomfort, dizziness, and even fainting. Many patients struggle for years without receiving a correct diagnosis. Mistaking their symptoms for anxiety or general fatigue.

Let’s guide you through its signs and symptoms in detail. So, you can easily identify it and know what to do if you have POTS.

At Iluka Medical Centre, we ease the challenges that come with POTS for you. Our team of highly experienced doctors provides evidence-based treatments and compassionate care to help patients manage this condition effectively.

If you or a loved one is experiencing POTS symptoms. Our specialists are here to help with proper diagnosis and personalised management plans.

What is POTS (Postural Orthostatic Tachycardia Syndrome)?

Postural orthostatic tachycardia syndrome (POTS) is a condition where the heart rate increases abnormally when a person moves from a lying to a standing position. The body struggles to maintain blood pressure. Leading to symptoms like dizziness, fatigue, brain fog, and rapid heartbeat.

Some of its key identifiers include:

• An increase in heart rate of at least 30 bpm within 10 minutes of standing for adults. (40 bpm for teenagers).
• No significant drop in blood pressure. (A differentiating symptom of POTS from orthostatic hypotension.
• Symptoms persisting for at least three months, significantly affecting daily life.

Wondering why does it happen? Let’s find out.

Physiology Behind POTS:

Normally, when you stand, your body automatically maintains steady blood flow to the brain.

It is the duty of the autonomic nervous system. That constricts blood vessels and slightly increases heart rate. Then bring it back to normal. So that, position change doesn’t affect the body.

However, in POTS, this process of balancing coordination is disrupted. Causing excessive heart rate elevation and poor blood circulation. This disruption is shown in the form of varied symptoms. Let’s discuss them in detail.

POTS Symptoms: How it Affects the Body?

The symptoms of POTS can vary from person to person since each case is different. The variation ranges from mild to disabling ones, such as:

• Dizziness and Light-headedness: A feeling of near-fainting when standing up.
• Palpitations: A sensation of a rapid or irregular heartbeat.
• Fatigue: Extreme tiredness that does not improve with rest.
• Brain Fog: Difficulty in focus, forgetfulness, and mental confusion.
• Nausea and Digestive Issues: Including bloating, constipation, or diarrhoea.
• Shakiness and Tremors: Especially in the hands.
• Cold Hands and Feet: Due to poor blood circulation.
• Shortness of Breath: Even after minimal exertion.
• Sweating Abnormalities: Either excessive sweating or a lack of sweating.

Some patients with POTS also experience anxiety-like symptoms due to the activation of the autonomic nervous system.

All these POTS symptoms worsen after standing for long periods, in hot environments, or after consuming large meals. Now let’s discuss who is more likely to develop this life-threatening condition.

Who is at Risk for POTS?

Certain individuals are more prone to developing POTS disease due to genetic, medical, or environmental factors.

These higher-risk groups include:

Different risk factors & causes lead to diverse POTS patterns. Read on to find about them.

Types of POTS Based on Causes

Understanding the different types of postural tachycardia syndrome is crucial. As they show slight variation in symptoms, according to the cause behind them.

1. Neuropathic POTS

It is caused by small-fiber nerve damage that affects blood vessel constriction. The results are poor circulation in the lower limbs & abdomen.

Neuropathic POTS is common in individuals with diabetes or autoimmune conditions.

2. Hyperadrenergic POTS

A type of POTS linked to excessive norepinephrine (stress hormone). Hence, causing an overactive sympathetic nervous system.

Its symptoms include high blood pressure, excessive sweating, and tremors.

3. Hypovolemic POTS

Hypovolemic POTS occurs due to low blood volume. That reduces the body’s ability to circulate oxygen efficiently during movement changes.

It is common in patients with chronic dehydration or kidney disorders.

4. Secondary POTS

Secondary POTS means orthostatic tachycardia is caused by some other condition. Such as Lyme disease, diabetes, or multiple sclerosis.

Now moving towards diagnostic procedures.

How is POTS Diagnosed?

Since POTS syndrome shares symptoms with other conditions. A careful diagnostic process is essential for timely management.

Tilt Table Test

It is the specialised test for the diagnosis of postural orthostatic tachycardia syndrome. In this test:

• The patient is strapped to a motorised table.
• Table is slowly moved from lying to an upright position.
• Doctors monitor heart rate and blood pressure changes.

It confirms whether the patient meets the criteria for POTS or not. Means he will develop tachycardia and relative symptoms without any sign of hypertension.

Other Tests for POTS

• Active Stand Test: The patient stands up while doctors measure heart rate and blood pressure changes.
• Blood Volume Testing: It determines if low blood volume contributes to symptoms.
• Valsalva Manoeuvre: It tests the function of autonomic NS in regulating heart response.
• Quantitative Sudomotor Axon Reflex Test (QSART): It measures the ability of autonomic NS to control sweating in the body.

The doctor can also suggest some additional tests like MRI or blood work.

Is There Any Treatment for POTS?

Unfortunately, there is no definitive POTS treatment option.

However, you can manage it in most patients with diet, exercise, and medications. The flare-ups can be prevented effectively. And lifestyle can be improved via continuous medical care and monitoring.

POTS Syndrome Management

1. Medications

There is no specific medication available for postural orthostatic tachycardia syndrome. But for symptomatic management, doctors can prescribe:

• Beta-Blockers: They reduce heart rate and manage palpitations.
• Corticosteroids: They help kidneys to retain sodium, increase blood volume, and prevent dizziness.
• Vasoconstrictors: They constrict blood vessels and stabilise blood pressure.

The doctor will recommend varied combinations according to symptoms of patient.

2. Physical Activity

Mild to moderate exercise can also help in POTS syndrome management. It includes:

• Low-impact exercises like swimming and recumbent cycling to improve circulation.
• Strengthening leg muscles to help push blood back to the heart.
• Slow progression of activity to avoid worsening symptoms.

Remember to always perform activities in a closely monitored and controlled environment.

3. Dietary Changes

Diet components can help retain sodium in the blood and manage the POTS symptoms.

Also, avoid fatty meals to maintain your heart health and blood pressure. If possible, visit a dietitian to design an effective meal plan.

4. Preventing Flare-Ups

It is the most crucial measure since flare-ups can prove life-threatening.

• Avoid prolonged standing and sit whenever possible.
• Wear compression stockings to prevent blood pooling in the legs.
• Limit caffeine and alcohol, as dehydration caused by them can worsen symptoms.

Maintaining a proper routine and regular sleep cycle can also help in easing your body.

5. Monitoring Symptoms

To keep a record of your condition and avoid worsening:

• Keep a symptom diary to track triggers and identify effective treatments.
• Wear a heart rate monitor to adjust activity levels accordingly.

Self-monitoring is never enough. Arrange regular sessions with your healthcare provider for professional nursing.

When Should You See a Doctor?

Seek medical advice if:

• Symptoms persist for more than three months and affect daily life.
• You frequently experience dizziness, fainting, or extreme fatigue.
• Over-the-counter remedies (hydration, salt intake) don’t provide relief.

The sooner you start the treatment, the more effective it will be.

Are you or a loved one struggling with POTS symptoms?

Choose Iluka Medical Centre for Effective POTS Syndrome Management

At Iluka Medical Centre, we provide comprehensive care for POTS and other autonomic disorders. With our evidence-based measures and techniques.

Our experienced practitioners bring decades of expertise in various specialties. Like general practice, podiatry, psychology, and dietary health.

We offer:

• Services 7 Days a Week: Flexible scheduling options.
• Onsite Pathology & Allied Health Services: Full diagnostic support.
• Bulk Billing Facility: For eligible patients.

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