POTS is a rare condition that can lead to people feeling very lethargic and short of breath with palpitations. When someone has POTS, their heart rate increases significantly within 10 minutes of going from sitting to standing or the heart rate increases to over 120 beats per minute in that time.
Most people who have POTS initially seek medical attention because they feel extremely lethargic and feel like they have no energy. They get short of breath on very little exertion and sometimes on no exertion at all. They can sometimes feel light-headed and dizzy although it is rare for people with POTS to actually pass out. These symptoms tend to be unrelenting and often last for more than 6 months. They can affect people’s quality of life significantly and can affect how well people sleep. The symptoms can also predispose to low mood and depression.
POTS generally affects younger people (generally between 15-25 years old). Generally, as people get older, the symptoms disappear but it affects some throughout their life. Patients with POTS also tend to be female, although no one is quite sure why that is.
No one is quite sure what the cause of POTS is. There are several theories but none have been completely proven. Generally, POTS is thought of as a group of conditions which all, by various ways, lead to an increase in heart rate on standing. One possible mechanism, is that, for various reasons, the body is not as good at pumping the blood back to the heart. The reasons for this maybe that there isn’t enough blood volume in the body or that the nerves which co-ordinate the blood being returned to the heart aren’t functioning quite as well as they should.
There are many different reasons for someone to feel lethargic and short of breath with a fast heart rate. Therefore, the first thing to do is to make sure there is no other reason for these symptoms. This is generally done by blood tests and an ultrasound scan (echo) of the heart to make sure there are no abnormalities with the function of the heart.
Once other conditions have been ruled out, the next stage is a Tilt table test. This is a test where you lie on a table which is flat. It is then tilted up so you are almost standing. Your heart rate and blood pressure can be measured when lying down and standing. Typical changes in your heart rate and blood pressure can help make a diagnosis.
There are a number of ways to treat POTS. The main aim of treatments is to help the symptoms of POTS as there is (as yet) no way to cure the condition.
The various treatments are as follows:
Not all of these treatments work for everyone, your Cardiologist will discuss them in more detail with you and, with you, come up with a plan for how to try and get the symptoms under control.