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Postural Orthostatic Tachycardia Syndrome (POTS)

Postural Orthostatic Tachycardia Syndrome (POTS) , is a condition that can significantly impact your quality of life. Understanding this condition can help you learn how to cope and move forward with your life.

Below, we explore this condition, its symptoms, how it’s diagnosed, and the treatment options available.

What is POTS?

Postural Orthostatic Tachycardia Syndrome is caused by the body’s autonomic response system not functioning correctly. The truth is that our bodies do a lot of things without us ever needing to think about them, such as beating your heart, maintaining your blood pressure, helping you balance, breathing, and so on. Our autonomic nervous system regulates these responses. Yet, a problem with our autonomic responses can lead to serious issues.

The autonomic system is responsible for regulating our blood pressure. This means that when we sit up, lie down, stand up quickly, or get into other positions, our blood pressure stays the same. In a person with POTS, the autonomic system doesn’t properly regulate blood pressure and blood flow to the brain. As a result, when you move, you may experience dizziness, nausea, balance issues, and other problems.

POTS can be mild, or it can be severe — even disabling. It all depends on how badly the autonomic system is damaged.

Symptoms of Postural Orthostatic Tachycardia Syndrome

The symptoms of POTS are more noticeable when going from sitting to standing. While there’s no hard and fast cause of POTS, it’s possible that an injury or infection could trigger the onset of POTS. Stress can also trigger POTS attacks. However, in some cases, symptoms of POTS may appear with no obvious trigger.

A few common symptoms of POTS include:

• A noticeable jump in heart rate. This usually occurs when going from a sitting position to a standing position.
• Lightheadedness or dizziness. This can include instability (feeling as though you’re about to fall), vision issues, blurriness, or tunneled vision.
• Heart palpitations.
• Passing out. The sensation of lightheadedness or dizziness can lead to actually passing out
• Chest pain.
• Difficulty breathing. This can lead to difficulty in exercising — feeling that you can’t draw a breath or can’t get enough air into your lungs.
• Weakness, shaking, and tiredness. You may experience these even without moving from one position to another.
• Nausea.
• Cold or painful extremities, possibly with red and purple coloring. This is usually due to poor blood circulation in the legs.
• Headaches. This is also due to poor blood circulation caused by POTS.
• Difficulty sleeping. This can also manifest as insomnia.
• Difficulty concentrating. Poor concentration can be exacerbated by lack of sleep, headaches, and other physical symptoms caused by POTS.

As you can imagine, all of these symptoms or even various combinations of these symptoms can be caused by other conditions, not just POTS.

So, let’s talk a bit about how POTS is diagnosed and how to live with it.

Criteria for Diagnosing POTS

An erratic or abnormal heart rate that presents itself when a patient stands or moves suddenly is the most common and well-known POTS symptom. However, it’s certainly not the only one nor is it necessarily the only criteria for diagnosing POTS. There may be any or all of the symptoms described above, and a doctor must be sure that the symptoms really are caused by POTS and not another condition.

For an adult to be diagnosed with POTS, they must present with a 30 beats per minute (bpm) heart rate increase within the first ten minutes of standing. Your doctor will likely use a test called the “table tilt test” to determine if this is happening or not.

The table tilt test is a safe and effective way of monitoring how a patient’s blood pressure and heart rate responds after standing — without risking injury or fainting. The patient is strapped to a flat table in a lying position. Then the table tilts, lifting the patient into a standing position.

This makes the brain think that the body is standing up, and our autonomic systems react accordingly — or it doesn’t react. Heart rate, blood pressure, and other information are monitored during this test. Other tests may be ordered to rule out other conditions with similar symptoms before diagnosing you with POTS.

Treatment for POTS

If you or a loved one has been diagnosed with POTS, you might wonder: Now what? How can you live with this condition? POTS is a chronic illness. However, there are things that you can do to manage your condition. These include:

• Identifying triggers.
  There could be no definite cause for your POTS attacks. However, you might notice that you’re more likely to have an attack of POTS if you’re stressed, have had a bad sleep, or recently skipped a meal. If that’s the case, avoid or limit these triggers so you can manage your illness in the best way possible.
• Ensuring good nutrition and plenty of water.
  Eating well and staying hydrated is crucial to good health in any case. When it comes to POTS, a healthy body will have better circulation, good sleep, and be more or less ready to stay healthy. Low blood sugar, for example, can make people dizzy and lightheaded, even without POTS.
• Getting a good night’s sleep.
  A well-rested person is a healthy person. Getting adequate quality sleep might be tricky if you’re struggling with POTS-related insomnia. You might need to talk to your doctor about how to sleep better. By doing so, you can not only potentially reduce your POTS symptoms, but also improve your overall health and wellness.
• Exercising.
  Start off with a mild, manageable exercise that allows you to sit down (rowing, swimming, etc). Gradually build up your stamina, so that you can obtain adequate movement throughout your daily life.
• Brain rehabilitation.
  It can often be possible to identify underlying brain dysfunction that may be contributing to POTS. Therapies such as vestibular rehabilitation, vagal nerve stimulation and other neuro-rehabilitation may assist with treating any brain dysfunction.

Getting Help

POTS is a complicated condition, however there can be factors that may be treated. Since POTS is a condition that affects the whole body and many different functions, each person might have a different experience with POTS.

If you’re struggling to cope or find treatment that works for you give us a call on 03 9800 5350 to book in an appointment with our Neuro-Rehabilitation chiropractor, Dr. Matthew Holmes.

We can offer strategies and treatment methods that may help you lead a relatively normal life, even while living with POTS.