What is POTS?

What is POTS?

Postural Orthostatic Tachycardia Syndrome (POTS) is not a specific disease but a syndrome which is a collection of symptoms. Clinical diagnosis of POTS is defined as a heart rate increase of at least 30 beats per minute (bpm) from lying down to standing position within 10 minutes. This is typically diagnosed with the Tilt Table Test. The test is performed exactly how it sounds, by tilting the table while a patient is lying down. Normally, once the table begins to tilt and the body shifts, the autonomic nervous system signals the blood vessels in your legs to tighten and your heart to pump a bit faster to send blood back up to your brain. An abnormal response is when patients experience a rapid heart rate increase over 100 bpm, termed tachycardia, and/or have significant, abnormal changes in blood pressure. In some cases, this rapid change in blood pressure causes patients to pass out (syncope). This is a syndrome of orthostatic intolerance combined with excessive upright tachycardia, and usually without associated orthostatic hypotension. All variants of responses to this test have in common an excessively reduced venous return to the heart, or central hypovolemia, while upright.

What causes POTS?

POTS Syndrome may be caused by a variety of factors such as: bacterial infections, injuries, viral infections, surgeries, chemicals, vaccines, severe stress, past traumatic events over challenging the nervous system, and/or multitasking in overachieving. It may be one or a combination of these factors that can create a perfect storm to activate the sympathetic nervous system and start the stress response in an effort to defend and protect. This sympathetic nervous system, or “fight-or-flight” mode, can eventually lead to a cascade of symptoms.

How does it work?

The reason for this problem is a dysfunction of the autonomic nervous system (dysautonomia). The autonomic nervous system (ANS) is an umbrella category for the parasympathetic, the “rest and digest”, and sympathetic, the “fight or flight”, systems. Normal Autonomic function allows the body to switch back and forth between these systems with ease. When the Sympathetic stays in overdrive for too long it triggers a collection of many symptoms resulting in POTS and dysregulation of the Autonomic Nervous System. Problems occur within the autonomic nervous system when the stress is chronic, not acute. Chronic stress is when an immense amount of stress, whether that be physical or emotional, over an extended period of time gets the body stuck in sympathetic nervous system overdrive. Disorders of the ANS occur as a primary condition. Manifestations can involve any or all body systems but commonly affect the blood pressure and heart rate. This means that dysautonomia can manifest as several conditions, including but not limited to POTS.

So, if you’re still with me… chronic stress -> dysautonomia -> POTS.

Common Symptoms of POTS

• orthostatic intolerance
• light/noise sensitivity
• tachycardia
• bradycardia
• tension/migraine headaches
• fatigue
• dizziness
• exercise intolerance
• chest pain
• gastrointestinal issues
• shortness of breath
• insomnia
• blurry vision
• joint/muscle pain
• tingling in the legs
• feelings of heat
• sweating
• muscle weakness
• nausea
• menstrual irregularities