What is POTS

Postural . Orthostatic . Tachycardia .  Syndrome 

Definition

An excessive heart rate increments upon upright posture. A person with POTS will experience heart rates that increase 30 beats or more per minute upon standing and/or increase to 120 beats or more per minute upon standing (Grubb, 2000).

        There isn't quite one single definition for this. 

Some people may throw around the term POTS quite freely and dismiss it for what it really is. 

POTS is diagnosed on the basis of heart rate increase, not on the basis of a drop in blood pressure (as is the case with orthostatic hypotension and neurally mediated hypotension/NMH). Neurally mediated hypotension is commonly associated with POTS, but having NMH is not necessary for a diagnoses of POTS. 

The secondary symptoms of POTS vary significantly from person to person. 

POTS often caused a temporary rise in blood pressure immediately after standing because of the acceleration of the rate rate. Tachycardia is actually the body's defense mechanism against a lack of sufficient venous blood being returned to the heart. Sometimes the blood vessels/veins can become dialated in POTS patients, which causes pooling of blood. It is because of the pooling that the heart needs to beat more times in a minute to make up for the hypovolemia (low blood volume). 

Standing is a major issue for these individuals , and the length of time that one can comfortably stand greatly varies on a case to case and day by day basis. Patients may become dizzy, overheated, lightheaded, and develop strong chest pains from standing beyond "their limit". Blood pooling in the legs and abdomen may occur (which is the same you feel when water fills up in your mouth when you take a drink). Shortness of breath, tingling in legs, blurry vision, sweating, and temperature change from increased adrenaline production are the common symptoms of orthostatic stress or after standing too long. 

It is important to remember that POTS is not a disease, but rather a syndrome (a collection of symptoms).

 

Symptoms

POTS has many symptoms and can affect an individuals life drastically - but it varies from person to person and day to day. POTS patients use about three time more energy to stand than a healthy person (Grubb, 2002). It is as if these patients are running in place all the time. Activities such as housework, bathing and even meals can exacerbate symptoms (Grubb, Kanjwal & Kosinski, 2006). Research show that POTS patients' quality of life is similar to those with congestive heart failure and chronic obstructive pulmonary disease (Benrud-Larson).

Some symptoms include, but are not limited to:

• lightheadedness
• syncope or pre-syncope
• generalized weakness
• palpatations
• chest pain
• tremulousness
• nausea
• abdominal pain
• fatigue
• sleep disorders
• migraines
• tachycardia
• exercise intolerance 
• hypotension
• hypertension
• cognitive impairment
• hypovolemia
• arrhythmia
• hyperreflexia
• neuropathies
• polydispia
• chemical sensitivities
• RLS
• chills 
• and more...

Dysautonomia

POTS is a form of dysautonomia. Dysautonomia is the dysregulation of the autonomic nervous system. The autonomic nervous system controls everything in your body that is done without your knowledge. It is involved in the control of heart rate, blood pressure, temperature, respiration, digestion and other vital functions. Dysregulation of the autonomic nervous system can lead to the malfunction of the organs it regulates. For this reason, people with dysautonomia often have numerous symptoms. 

Misconceptions

• People just need to eat more salt: Yes, it is beneficial to increase your salt intake, but just increasing salt intake alone will not make POTS symptoms go away
• So your blood pressure is messed up, what's so bad about that? Blood pressure regularities is just one of the multiple symptoms that POTS patients manage. However, when our blood pressure drops, this leads to syncope or pre-syncope, dizziness, chest pains, blurred vision and more...
• Can't you just take medicine and make it go away? Pharmaceutical drugs do help some patients with their symptoms, but rarely does it completely resolve the symptoms. POTS patients are usually very sensitive to drugs and therefore it is very hard to find the right treatment for individuals. No two patients are alike and every patient needs specific individualized treatment.
• But you don't look sick? This is the hardest thing for POTS patients to deal with, as well as anyone with an invisible illness. Just because we look okay on the outside, doesn't mean when feel okay on the inside. You can't see ones blood pressure, heart palpitations, and other symptoms we may be having, but it's there and it's real. We try our best to look nice on the outside as if we were healthy, it makes you feel better. Remember, one hour we may be fine and the next could be ruined.