POTS Syndrome

Postural orthostatic tachycardia syndrome or POTS refers to a group of conditions which have OI or orthostatic intolerance as their main symptom. Orthostatic intolerance refers to a disorder wherein there is drastic reduction in blood flow to the heart, when a person gets up into a standing after being a state of lying down. One of the main signs of OI is fainting or dizziness.

Individuals affected by POTS may also experience a rapid increase in the rate of heart beat by nearly thirty beats a minute along with lightheadedness, after getting up from a lying down position. POTS can affect anyone, but generally tends to affect women in the age group of fifteen to fifty years. A few women may experience the syndrome just after their menstrual periods.

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POTS can be severely debilitating and can affect the daily life of a patient. Individuals may not be able to go to work or attend school. Some individuals affected by severe POTS may find themselves completely incapacitated during an attack.

Symptoms of POTS syndrome

Some of the signs and symptoms of POTS are discussed below:

  • One of the primary symptoms of POTS is the rapid rise in the rate of heart beats when an affected individual gets up after being in a position of lying down. The rate of heart beat can elevate to as high as 120 beats per minute within ten minutes after getting up.
  • The abnormal increase in the rate of heartbeat may often be accompanied by a drop in the flow of blood to the heart as well as a drop in the blood pressure levels. This may result in a number of symptoms that accompany hypotension as well as the signs mentioned below:
    • An increased sense of thirst and the need to consume liquids
    • Dizziness, not associated with vertigo and lightheadedness
    • Severe fatigue and tiredness
    • Inability to engage in physical activities or exercise
    • Fainting or fainting spells
    • POTS can result in dysfunction of the autonomic system. This can result in problems of the gastrointestinal system and symptoms such as:
      • Discomfort or pain in the abdomen
      • Nausea
      • Constipation or irregular bowel habits
      • Bloating
      • Diarrhea
      • Vomiting
      • POTS may also cause acute or prolonged hypoperfusion of organs and tissues in the upper regions of the body. This in turn may result in symptoms such as:
        • Ocular irregularities or disturbances in vision
        • The extremities may become cold
        • Confusion or disorientation
        • Headaches
        • Tinnitus
        • Discomfort or pain in the chest
        • Dyspnea
        • Experience of tremors
        • Weakness of the muscles
        • POTS can also result in decreased levels of norepinephrine and epinephrine, which in can cause the below mentioned symptoms:
          • Feelings of increased fear
          • Chills
          • Flushing
          • Fidgetiness or nervousness
          • Increased body heat
          • Over stimulation
          • POTS may occasionally result in cerebral hypoperfusion which in turn can lead to difficulties in emotive and cognitive behaviors. It is important to note that symptoms that persist when in a position of lying down, may not be ascribed to cerebral hypoperfusion. Some symptoms include:
            • Difficulties in coming up with the correct word
            • Brain fog
            • Sleep abnormalities
            • Diminished mental strength
            • A feeling of being burnt-out
            • Depression
            • Decreased concentration abilities

It is important to note that most of the symptoms of POTS are similar to those elicited by GAD or generalized anxiety disorder, and hence the condition is often misdiagnosed as GAD.

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One may also note that a lot of patients will assume the lying position to alleviate the symptoms of POTS. However, if a patient indulges in this, every time he/she has a POTS attack, then the symptoms may develop even during a position of lying down. Hence, it is necessary to seek medical attention after the diagnosis of POTS for easing the symptoms of POTS.

Causes of POTS syndrome

The exact cause of POTS is not known. A lot of individuals affected by the disorder tend to elicit the symptoms during adolescence and teens when there is a spurt in growth activities. Such symptoms generally tend to fade away by the time they reach the 20s.

  • Some individuals may develop the condition after a bacterial or viral attack such a pneumonia, etc.
  • A few may develop POTS after a trauma such as an automobile accident. Any damage to the autonomic nervous system due to trauma, diseases, etc. can also result in the symptoms of POTS
  • Research has also shown that individuals who have a family history of OI are more vulnerable to developing POTS than others. Hence, the condition has genetic causes as well.

Treatment of POTS syndrome

POTS may be treated in a number of ways which include the following:

  • Dietary changes that include intake of plenty of water and sports drinks; abstinence from alcohol; consumption of small, frequent meals; intake of low carbohydrate and gluten-free diets and intake of increased amounts of salt.
  • Intake of medications to treat B12 deficiency; intake of sodium supplements and the consumption of other drugs such as Antidepressants, Beta-blockers, anti-anxiety drugs, etc. as prescribed by the doctor.
  • Performance of aerobic exercises and other forms of physical exercise and therapies to increase the muscle strength.
  • The use of pressure clothing to regulate the blood pressure via the use of external body pressure.
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