Postural Orthostatic Tachycardia Syndrome (POTS): Symptoms, Causes, And Treatment


Postural Orthostatic Tachycardia Syndrome (POTS) is a complicated and frequently debilitating disorder that influences the autonomic nervous system, imposing a variety of signs that seriously impact daily reality. In this thorough article, we can delve into the complexities of POTS, analyzing its symptoms, underlying causes, diagnostic demanding situations, and diverse treatment modalities designed to manage and improve the satisfaction of existence for the ones troubled by this syndrome.

Overview of Postural Orthostatic Tachycardia Syndrome (POTS)

POTS is a body of dysautonomia, a disorder of the autonomic nervous system (ANS) that controls spontaneous bodily components which include heart rate, blood strain, digestion, and body temperature. The hallmark characteristic of POTS is a strange growth in heart rate that happens upon standing, contributing to another bunch of symptoms.

Symptoms of Postural Orthostatic Tachycardia Syndrome

The condition often affects more youthful individuals, frequently appearing in childhood or early maturity, and disproportionately affects women.

Symptoms of Postural Orthostatic Tachycardia Syndrome

POTS provides a numerous array of signs and symptoms, which can range in severity and manifestation from person to character. Common signs encompass:

  • Tachycardia: A rapid coronary heart rate is a descriptive trait of POTS, specifically upon standing. The heart rate may increase with the aid of 30 beats compatible with a minute (bpm) or more inside the first 10 minutes of standing.
  • Dizziness and Lightheadedness: People with POTS often undergo dizziness or lightheadedness, especially whilst transitioning from a seated or relaxed function to a standing one.
  • Fatigue: Persistent fatigue is a recurring symptom, regularly depicted as overwhelming and inapplicable to physical work.
  • Cognitive Impairment: POTS can result in difficulties with attention, reminiscence, and average cognitive features, frequently referred to as “brain fog.”
  • Shortness of Breath: Some people with POTS may have trouble breathing or a sensation of breathlessness.
  • Exercise Intolerance: Physical hobbies may additionally trigger or exacerbate signs, mainly exercise intolerance and avoidance of activities that were formerly nicely tolerated.
  • Tingling or Numbness: Peripheral neuropathy symptoms, along with tingling or numbness, might also occur inside the extremities.
  • Headaches: Headaches, together with migraines, are common in people with POTS.
  • Sweating Abnormalities: POTS can affect sweat manufacturing, leading to changes in perspiration styles.

It is crucial to note that the severity and mixture of signs and symptoms can vary, making POTS a hard situation to diagnose and control.

Causes and Triggers of POTS

The exact cause of POTS is often multifactorial, with diverse contributing elements and triggers. Understanding these factors is crucial for a complete method of prognosis and remedy. Potential causes and triggers encompass:

1. Hyperadrenergic POTS

This subtype of POTS is characterized by an immoderate release of norepinephrine, a neurotransmitter that regulates heart charge and blood strain. Genetic factors, as well as situations like hypermobility spectrum problems, might also contribute to hyperadrenergic POTS.

2. Hypovolemic POTS

Insufficient blood quantity, whether or not because of dehydration, blood loss, or other elements, can cause hypovolemic POTS. Conditions including diabetes or excessive use of diuretics may additionally make contributions to this subtype.

3. Autoimmune Disorders

Some individuals with POTS have autoimmune situations, suggesting an immune system disorder as a capability contributing element.

4. Small Fiber Neuropathy

Damage to the small nerves that control autonomic function, known as small fiber neuropathy, has been located in people with POTS.

5. Infections

POTS symptoms may increase following viral or bacterial infections, suggesting a potential role of post-infectious dysautonomia.

6. Joint Hypermobility

There is an amazing affiliation between POTS and joint hypermobility problems, along with Ehlers-Danlos syndrome (EDS).

7. Autoimmune Neuropathies

Conditions like Sjogren’s syndrome and lupus, which involve autoimmune attacks on the anxious device, might also contribute to POTS improvement.

Diagnosis of Postural Orthostatic Tachycardia Syndrome

Diagnosing POTS may be tough due to the range of signs and symptoms and the overlap with other scientific situations. The diagnostic standards for POTS typically encompass:

  • Heart Rate Increase: A heart rate boom of at least 30 bpm (or a charge exceeding one hundred twenty bpm) within the first 10 mins of standing, within the absence of orthostatic hypotension.
  • Symptoms on Standing:  The presence of signs like dizziness, lightheadedness, or fainting upon status.
  • Absence of Orthostatic Hypotension: Orthostatic hypotension, a sizable drop in blood stress upon status, isn’t present or is not the primary motive of symptoms.
  • Symptoms Relief with Recumbency: Symptoms improve or resolve upon lying down.

To verify a POTS analysis and discover potential contributing factors, additional testing may be required, along with autonomic function checks, blood volume assessment, and tilt desk checking out.

Treatment Approaches for Postural Orthostatic Tachycardia Syndrome

Managing POTS calls for a multidisciplinary method that addresses both symptom remedies and underlying reasons. Treatment strategies may also consist of:

Lifestyle Modifications

  • Hydration: Maintaining fluid intake is important to support blood quantity and decrease symptoms.
  • Salt Intake: Increasing salt intake can help combat hypovolemia, but this must be performed under the control of a healthcare professional.

Physical Counterpressure Maneuvers

  • Compression Garments:  Wearing compression stockings or belly binders can assist in preventing blood pooling inside the decreased extremities, reducing signs and symptoms.


  • Beta-Blockers: Medications like propranolol or metoprolol can be prescribed to govern heart price and ease symptoms.
  • Fludrocortisone: This medicinal drug helps increase blood extent by promoting sodium and water retention.
  • Midodrine: A vasoconstrictor that helps increase blood stress, mitigating symptoms.
  • Pyridostigmine: This medicine enhances neurotransmission and can be beneficial in a few instances.

Exercise and Physical Therapy

  • A cautiously customized exercising regimen, under the monitoring of a bodily therapist, can assist in enhancing tolerance to bodily interest and reduce signs and symptoms.

Suggestions for Changing Your Diet

  • Making changes to the foods you eat can also include increasing your intake of fluids and salt, and avoiding triggers like caffeine and alcohol.

Problems and Future Prospects

Despite developments, there are still several challenges in POTS handling alongside information processing. Because of the complications of the situation, it is difficult to develop standard treatment plans, which stresses the value of individualized therapy. To further improve targeted and effective treatments, current research endeavors to determine the most efficient mechanisms underlying POTS.


In summary, postural orthostatic tachycardia syndrome (POTS) is a complicated and frequently baffling condition that has a significant influence on the lives of millions of people who are impacted. Considering the wide range of diseases and factors that influence functioning, a thorough and individualized approach to evaluation and treatment is essential.

Although there doesn’t seem a single prescription that works for everyone, people with PTSD, also known as post-traumatic stress disorder, can live better lives by managing their symptoms with a combination of supporting assistance, modifications to their lifestyles, and medications.

If research on solving the complexities around this situation continues, the field of medicine is better equipped to offer effective and customized solutions. This makes one hope for improved outcomes and an especially positive outlook for those in control of POTS.


  • Bryarly M, Phillips LT, Fu Q, Vernino S, Levine BD. Postural Orthostatic Tachycardia Syndrome: JACC Focus Seminar. J Am Coll Cardiol. 2019 Mar 19;73(10):1207-1228. [PubMed]
  • Low PA, Sandroni P, Joyner M, Shen WK. Postural tachycardia syndrome (POTS). J Cardiovasc Electrophysiol. 2009 Mar;20(3):352-8. [PMC free article]

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Dr. David G Kiely is a distinguished Medical Reviewer and former General Medicine Consultant with a wealth of experience in the field. Dr. Kiely's notable career as a General Medicine Consultant highlights his significant contributions to the medical field.

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