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Thursday, 4 June 2015

POTS - What is it?

What does POTS stand for? 

Postural Orthostatic Tachycardia Syndrome.

So what is POTS? 

It is an abnormal increase in a persons heart rate after sitting or standing up. 
When a healthy person stands up, to avoid blood dropping down into the limbs and abdominal cavity, blood vessels contract immediately and heart rate increases slightly to maintain blood supply to the heart and brain.
But In a person with Pots, for some reason the autonomic nervous system doesn't function properly, so when you become upright there is a drop in blood supply to the heart and the brain. As a reaction to this, your heart begins to race and your body produces lots of the hormone noradrenaline (this is one of the hormones that prepares you for "fight or flight"). 

What are the symptoms of POTS? 
The following was taken from this website: http://www.potsuk.org/symptoms

Symptoms

Orthostatic intolerance:

is a term that is sometimes used to describe symptoms of PoTS. It means symptoms that occur on standing and are relieved by lying down. In addition to heart rate and blood pressure, other bodily functions that are regulated by the autonomic nervous system can be affected.

Symptoms can be debilitating, ranging from mild to severe and varying from day to day.


  • Dizziness or light-headedness or presyncope (almost fainting)

These symptoms usually occur when standing up,  but can occur with prolonged sitting.

  • Syncope (fainting or blackouts)

Approximately  30 % of people with PoTS experience fainting.

  • Palpitations

Palpitations are a sensation of your heart pounding in your chest.

  • Headaches

Approximately two thirds of those with PoTS have orthostatic headaches which means they occur as a result of being upright and may be caused by reduced blood supply to the brain.  Most people with PoTS also have migraine type headaches.

  • Tiredness or weakness

These are common symptoms of PoTS and can last for a considerable time after a bout of symptoms of PoTS.

  • Brain fog

People with PoTS often complain of ‘brain fog’ which is difficulty in thinking or concentrating.

  • Shakiness or Tremulousness

This is often worse with upright posture

  • Shortness of breath

Patients can feel breathless when standing up or with slight exertion.

  • Chest pain

Chest pain is fairly common in patients and can be worse when upright. The cause is not clear.

  • Excessive or patchy reduced sweating
  • Gut problems

Nausea is common. Other symptoms include diarrhoea, constipation, bloating, abdominal pain and vomiting.  Many people with PoTS are told that they have irritable bowel syndrome.

  • Poor sleep

Many patients with PoTS have insomnia. This can be trouble getting to sleep,  waking in the middle of the night and trouble getting back to sleep.

  • Visual problems

This can be described as excessive glare, blurred or tunnel vision.

  • Bladder problems


Triggers which may worsen symptoms

  • Excess heat
  • After eating – especially refined carbohydrate eg sugar, white flour
  • Speed of positional change – don’t stand up quickly
  • Dehydration
  • Time of day (may be worse in the morning, especially rising after wakening)
  • Menstrual period
  • Deconditioning or prolonged bed rest
  • Alcohol which dilates blood vessels
  • Exercise (occasional exercise can cause one to feel worse, but an ongoing exercise program can improve symptoms)
How is POTS diagnosed? 

The most frequently used test is the Tilt Table Test. 

This test is carried out in hospital as an outpatient, you will be strapped to a specifically designed bed with a footplate attached to it. During the test your blood pressure and heart rate will be monitored continuously. The bed will be tilted upright to about 70 degrees for up to 40 minutes or until you faint. (This is nothing to worry about as you are in safe hands) 

You may be given medication to take during the test. All observations are recorded and once the test has been completed they will be able to tell you from the observations whether or not you do have POTS.

So what are the causes of POTS? 


In many cases, the cause of this nervous system problem is not known.

Teenagers will sometimes develop PoTS after a growth spurt and find it gradually disappears a few years later.

It can also develop later in life – typically at any age from 15 to 50 – and is much more common in females. It can develop suddenly after a viral illness or traumatic event, or during or after pregnancy.

Some of the other known causes are:

  • an underlying disease – such as diabetesamyloidosissarcoidosislupusSjogren's syndromemultiple sclerosis or cancer (chemotherapy can also sometimes trigger it)  
  • Ehlers-Danlos Syndrome - A genetic connective tissue disorder which effects the productions of collagen. 
  • poisoning – with alcohol or certain metals 
  • inheriting an abnormal gene, which causes too much of the "fight or flight" hormone noradrenaline to be produced – this inherited form of PoTS is less common 

PoTS can be misdiagnosed as chronic fatigue syndromeanxiety or panic attacks.



I am not a doctor and although I do have suspected POTS (my genetics doctor wrote in his report) it has not yet been confirmed so I would not want to give anyone wrong advice on how to live with POTS, medication or self care. Instead I would strongly recommend visiting your GP and discussing this with them. 

I hope this has helped someone :) x

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