Learning About Postural Orthostatic Tachycardia Syndrome (POTS)

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What is POTS?

Postural orthostatic tachycardia syndrome (POTS) is a fast heart rate (tachycardia) that starts after you stand up. This can suddenly happen as long as 10 minutes after you stand.

What happens when you have POTS?

With POTS, the body does not control blood pressure or heart rate as it should after you stand up. So for a brief time, you may not get enough blood to your brain.

People with severe fatigue and dizziness may find it hard to keep up with daily living. But treatment can help.

What are the symptoms?

POTS can make you feel dizzy and light-headed. You may faint. You may also feel tired. Blurred vision and feeling anxious are also symptoms. And you may have trouble with keeping your attention focused. Symptoms can range from mild to severe.

Some things can make symptoms worse. These include heat, eating, exercise, showering, sitting too long, and menstrual cycle changes.

When you first notice symptoms, sitting or lying down may help you feel better.

What causes it?

POTS may follow a viral illness, a surgery, pregnancy, bedrest, or a severe trauma. Experts don't understand what causes it, but different body systems seem to be out of balance.

How is POTS diagnosed?

To learn what is causing your symptoms, your doctor may:

  • Ask about your symptoms, including when and how they started.
  • Check how your blood pressure and heart rate change when you move from lying down to sitting to standing.
  • Do a tilt table test. The test uses a special table that slowly tilts you to an upright position. It checks how your body responds when you change positions.

How is POTS treated?

Work with your doctor to find the right mix of treatments. These treatments may include:

  • Taking medicine prescribed by your doctor. For some people, taking medicine that's normally used for high blood pressure can help. Taking medicine that keeps the body's fluids balanced may also help.
  • Everyday self-care. These practices can be a key part of helping the body get back in balance.
    • Drink plenty of fluids. For many people, low body fluid is part of what makes POTS symptoms worse.
    • Eat the amount of salt your doctor tells you to. Salt helps keep up the body's fluid level.
    • Try a special exercise program. Your doctor may give you a program of specific exercises. You start short and slow, especially if fatigue is a problem. Add a little at a time. At first, you only do exercise when you're reclined. After a few weeks, you start to add upright exercise.
    • Keep track of your symptoms and what makes them better and worse.

When should you call for help?

Call 911 anytime you think you may need emergency care. For example, call if:

  • You passed out (lost consciousness), and it feels different than your typical episode or you don't recover as quickly as you have in the past.

Call your doctor or nurse call line now or seek immediate medical care if:

  • Your symptoms are getting worse. For example, you are more dizzy or light-headed.

Watch closely for changes in your health, and be sure to contact your doctor or nurse call line if:

  • You do not get better as expected.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse call line if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

Where can you learn more?

Go to https://www.healthwise.net/patientEd

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