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What is it?

Postural tachycardia syndrome is an abnormality of the functioning of the autonomic (involuntary) nervous system (sometimes called ‘dysautonomia’). The autonomic nervous system (ANS) controls heart rate and blood pressure regulation, digestion, bladder control, sweating and stress responses. When the ANS isn’t working properly there’s a drop in blood supply to the heart and brain when you become upright and the heart races to compensate for this.

The majority of PoTs sufferers are women.

What Does It Feel Like?

Living with PoTS is an internal battle, a merry-go-round of symptoms which have a tendency to pop up at unexpected times. Simple tasks can seem monumentally difficult to a PoTS sufferer who has to deal with shortness of breath, extreme blood pressure variations, severe fatigue, sweating or chills on a daily basis. Not to mention the stigma attached to invisible conditions which is a whole other problem for sufferers.

Symptoms are, but not limited to, dizziness, fainting, palpitations, headaches, weakness, brain fog, chest pain, shakiness, digestion issues, blurred vision and bladder problems.

Some activities may make symptoms worse such as feeling hot, eating, strenuous exercise and menstruation.

How Is It Diagnosed?

People may often be diagnosed by a cardiologist, neurologist or other specialist as general Doctors don’t have sufficient enough training to diagnose PoTS.

To be given a diagnosis of PoTS, a person needs to be able to show a catalogue of symptoms when coupled with an increase of heart rate upon standing. If the heart rate increases by 30 bpm or more (40 bpm in those aged 12-19) after 10 minutes of standing, or if it increases to more than 120bpm then a diagnosis of PoTS is given.

Blood tests and other appropriate investigations may give a clearer diagnosis.

The tilt table test and the active stand test (both heart rate and blood pressure monitoring) are the most common, as is an electrocardiogram (ECG).

What Treatments Are Available?

Self-care activities – drinking more fluids, avoiding long periods of standing, introducing more salt into the diet, plus other methods – are advocated to see if these improve symptoms.

There is no medication specifically for the treatment of PoTS, however other medications such as beta blockers (decrease heart-rate), fludrocortisone (decreases sodium loss) and antidepressants may be prescribed dependent on the symptoms the person is showing.

What does it feel like to live with POTS?


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Written by Wendy England