Postural Orthostatic Tachycardia Syndrome or POTS is a dysautonomia disease, affecting the autonomic nervous system disease. Affecting women more than men, POTS tend to manifest itself during teenage years, or after a traumatic event. Its key characteristic is the inability of blood to reach the brain forcing one’s heart to beat faster to accommodate the drop in blood volume. The most common symptoms are feeling light-headed or nauseous when one stands up after being prone for a long period of time.
What are the Symptoms of POTS?
There are many symptoms, but the most common reported symptoms are:
- fatigue
- heart palpitations
- light-headed
- headaches/ migraines
- nausea
- abdominal or general pain
What Causes POTS?
POTS is caused when the nervous system that regulates blood flow does not work properly. When a person stands, gravity pulls blood down toward the feet. When this happens blood vessels compensate by constricting itself to push blood back up toward the brain. It’s why people feel a head rush, when one stands too quickly after sitting for a short time period. In a person with POTS, the blood vessels do not properly constrict to regulate blood flow. Therefore, the heart must work harder to pump blood up. This causes the heart to beat faster, a principle symptom of POTS.
How do I Know if I have POTS?
The issue with diagnosing POTS is that it shares symptoms with many other diseases. Doctors will run test such as an echocardiogram, a 3D ultrasound of the heart to check for heart deformities as well as an electrocardiogram (EKG) to check for abnormal heart rhythm. Blood tests may be performed to rule out any other diseases such as hormonal imbalances, or kidney complications. There is one test that is considered the gold standard for diagnosing one with POTS, which is the tilt-table test.
The table test is a method that cardiologist use to test blood pressure in different positons. Initially, the patient will be placed prone onto the table and strapped in. EKG probes will be connected to your chest to monitor the heart and blood pressure readings. The provider will gradually start tilting the table to an upright position and constantly monitor one’s vitals.
What the provider is looking for is one’s heart beat to increase around 30-40 BPM over 10-15 minute period, while blood pressure remains the same. At the same time, one may start feeling light-headed or dizzy and possibility faint. The increase heart rate with no change in blood pressure is important because it helps to rule out other heart diseases. During the test, the provider may inject drugs such as Isoproterenol which simulates adrenaline, to gain further insights on one’s condition. After the test is over, the patient will be returned to the prone position to recover before being allowed to go home.
Once one has been diagnosed, there are a few treatment options for managing POTS.
What are my treatment options?
There is no cure for POTS; the best course of action is to manage the symptoms by making lifestyle changes. Along with diet and exercise, there are a few changes one should implement to manage the symptom triggers.
Exercise
Exercise is important to help your blood circulation. Exercise regimen should have a gradual timeline, starting from a slow pace and ramping up to one’s comfort level. When one is unable to get up and out, stretches and planking is useful to stay active and keep blood from pooling in the legs. Light walking or jogging is also helpful to heart strong, but one should keep an eye on any triggers while exercising.
Diet
Along with exercise, remember that diet is just as crucial. Ironically, people who are suffering from POTS, should increase their sodium intake. It is not uncommon for sufferers of POTS to take salt tablets or eat saltier food to help manage their blood circulation. However, one should be caution regarding eating processed food such as potato chips and crackers, which have low nutritional value. Be wary of high-carbs foods, which may trigger symptoms. Always drinks enough fluids throughout the day will also help to stay hydrated and manage blood volume. Lastly, for ones who suffer from the symptoms more frequently, make sure your surrounding is safe.
Environmental Factors
To ensure one’s safety, making changes around the home should be taken into consideration. If one is going out, go out as a group to ensure one’s safety while outdoors. Around the home, ensure the room is safe from head injury in case one faints. Items such as nightstands be kept further away from the bed, to lessen chances of injury when getting out of bed. Consider installing grab bars in the shower to help keep from falling when getting in and out. In all rooms, have an area to lay down right away such as a recliner, or a sofa to be able ease the symptom. Also move objects such as coffee tables and bookcases away from common walkways, to lessen the chance of falls with major injury. Remember it is important to keep a holistic approach to managing one’s condition.
If one does believe they may have POTS, one should contact their Primary Care Physician and run test to give a proper diagnosis. Remember the most important thing is to listen to one’s body and know the triggers that causes the symptoms to minimize their impact. Be in control of your own health, and while there is no cure for POTS, you can manage your own body.
If you like more information on POTS, please check out the resources below.
https://rarediseases.info.nih.gov/diseases/9597/postural-orthostatic-tachycardia-syndrome
Postural Orthostatic Tachycardia Syndrome (POTS) | Johns Hopkins Medicine
