Feeling faint? It may be POTS..

Lisa Absher
14 hours ago
2 min read

Postural tachycardia syndrome (POTS) is a condition affecting between 1 and 3 million people in the United States. The primary sign of POTS is a heart rate that increases by 30 or more beats per minute within ten minutes of standing up. A brief increase in heart rate during the first 20 seconds of standing is normal, however with POTS, heart rate will continue to increase a minute or longer after standing. Other common symptoms include heart palpitations, shortness of breath, lightheadedness, fainting, blurred vision, nausea, headache, and “brain fog”. Many of these symptoms are relieved by lying down.

The cause of POTS is unknown but may develop following one or more of the following conditions: dehydration, prolonged bedrest, neuroendocrine dysfunction, or infection. POTS generally occurs in adults between the ages of 15-50 years old disproportionately affects females, almost five times as often as men. Most patients are white females of child-bearing age.

While POTS is not an inherently dangerous condition, the symptoms associated with it can often become debilitating. Patients with this condition often develop anxiety from fear or anticipation of fainting. Symptoms can severely limit the daily activities and working ability of patients. There is currently no FDA-approved treatment for managing POTS, although some lifestyle modifications and medications have been shown to be useful.

Treatment recommendations include increasing both water and salt intake, to help increase and retain blood volume. Large meals, alcohol, hot weather, and caffeine may aggravate symptoms, so it is generally recommended to avoid these things. While palpitations and shortness of breath may make exercise difficult, cardio exercise is largely recommended. With time, exercise should become easier as symptoms begin to improve. Patients should also try to stay upright as much as possible and avoid prolonged bedrest. Compression stockings may help. While there is no recognized cure for POTS, some medications have proven helpful for managing symptoms. Beta blockers, midodrine, fludrocortisone, or pyridostigmine are the most commonly used medications.

For many patients, POTS may clear up on its own. Up to 20% of patients report complete resolution of symptoms within 5 years of diagnosis. For those with chronic cases, following the above recommendations can be helpful for managing symptoms.

References:

"Postural Orthostatic Tachycardia Syndrome (POTS)". Johns Hopkins Medicine. 21 December 2022. Archived from the original on 13 November 2023. Retrieved November 13, 2023.
Low PA, Sandroni P, Joyner M, Shen WK (March 2009). "Postural tachycardia syndrome (POTS)". Journal of Cardiovascular Electrophysiology. 20 (3): 352–358. doi:10.1111/j.1540-8167.2008.01407.x. PMC 3904426. PMID 19207771.
Reis Carneiro D, Rocha I, Habek M, Helbok R, Sellner J, Struhal W, Wenning G, Fanciulli A. Clinical presentation and management strategies of cardiovascular autonomic dysfunction following a COVID-19 infection - A systematic review. Eur J Neurol. 2023 May;30(5):1528-1539. doi: 10.1111/ene.15714. Epub 2023 Feb 8. PMID: 36694382.
Raj V, Opie M, Arnold AC. Cognitive and psychological issues in postural tachycardia syndrome. Auton Neurosci. 2018 Dec;215:46-55. doi: 10.1016/j.autneu.2018.03.004. Epub 2018 Mar 27. PMID: 29628432; PMCID: PMC6160364.
Bhatia R, Kizilbash SJ, Ahrens SP, Killian JM, Kimmes SA, Knoebel EE, Muppa P, Weaver AL, Fischer PR. Outcomes of Adolescent-Onset Postural Orthostatic Tachycardia Syndrome. J Pediatr. 2016 Jun;173:149-53. doi: 10.1016/j.jpeds.2016.02.035. Epub 2016 Mar 12. PMID: 26979650.

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