Please remember, we are not medical professionals and cannot provide medical advice. It is essential to seek the opinion of a qualified healthcare professional for any health concerns or before making any decisions related to your medication or treatment. This information is for general knowledge and informational purposes only and does not constitute medical advice.

Postural Orthostatic Tachycardia Syndrome (POTS) is a complex medical condition characterised by an abnormal increase in heart rate that occurs upon standing up from a lying down (supine) position. This increase in heart rate is often accompanied by a variety of other symptoms that can significantly impact a person's daily life.

While the exact diagnostic criteria can vary slightly among different medical sources, the generally accepted definition involves the following:

• Sustained increase in heart rate upon standing: Specifically, an increase of 30 beats per minute (bpm) or more within 10 minutes of standing up from a supine position. In adolescents (12-19 years old), the heart rate increase must be 40 bpm or more.
• Absence of orthostatic hypotension: This means that while the heart rate significantly increases, there is typically no significant drop in blood pressure (or only a slight, transient drop) upon standing. Orthostatic hypotension, in contrast, involves a significant drop in blood pressure upon standing, leading to dizziness and lightheadedness.
• Chronic symptoms: The symptoms associated with the heart rate increase must be present for at least 3 to 6 months.
• Associated symptoms: The increase in heart rate is often accompanied by a wide range of other symptoms that can vary in severity and frequency among individuals. These can include:
  • Lightheadedness or dizziness
  • Fatigue (often debilitating)
  • Brain fog (difficulty concentrating, memory issues)
  • Headaches
  • Nausea
  • Tremors or shaking
  • Sweating (excessive or decreased)
  • Palpitations (feeling a rapid, pounding, or fluttering heartbeat)
  • Chest pain or discomfort
  • Shortness of breath
  • Visual disturbances (blurred vision, tunnel vision)
  • Exercise intolerance
  • Sleep disturbances
  • Anxiety

Key aspects of POTS:

• Dysautonomia: POTS is considered a form of dysautonomia, which is a disorder of the autonomic nervous system (ANS). The ANS controls involuntary bodily functions such as heart rate, blood pressure, digestion, and temperature regulation. In POTS, there appears to be a malfunction in how the ANS regulates blood flow and heart rate in response to changes in body position.
• Heterogeneous Condition: POTS is not a single disease but rather a syndrome, meaning it's a collection of symptoms that tend to occur together. The underlying causes and specific mechanisms can vary among individuals.
• Multiple Potential Causes: The exact cause of POTS is often unknown (idiopathic). However, it can sometimes be triggered by or associated with:
  • Viral or bacterial infections
  • Major surgery or trauma
  • Pregnancy
  • Autoimmune disorders (e.g., Sjogren's syndrome, lupus)
  • Connective tissue disorders (e.g., Ehlers-Danlos syndrome)
  • Mast cell activation syndrome (MCAS)
• Diagnosis of Exclusion: POTS is often diagnosed after ruling out other conditions that can cause similar symptoms, such as cardiac abnormalities, orthostatic hypotension, and endocrine disorders.
• No Single Cure, but Manageable: Currently, there is no cure for POTS, but various treatment strategies can help manage symptoms and improve quality of life. These may include lifestyle modifications (e.g., increased fluid and salt intake, compression garments, exercise programmes), medications, and therapies.

Living with POTS can be challenging due to the unpredictable and often debilitating nature of the symptoms. However, with proper diagnosis and management, many individuals with POTS can experience significant improvement in their symptoms and overall functioning.