Description
Postural Orthostatic Tachycardia Syndrome, POTS, is a syndrome of the cardiovascular autonomic system with characteristic symptoms of tachycardia and orthostatic intolerance upon standing. The most commonly seen symptoms in-clinic include weakness, dizziness, rapid heartbeat, and palpitations upon standing. Other symptoms often reported but not prevalent for every patient are reduced exercise capacity, deconditioning, gastrointestinal disorders, dyspnea, gastrointestinal disorders, and brain fog. POTS affects mainly women (80%) of child-bearing years from ages 10-45. POTS has a 0.2 – 1.0% prevalence in developing countries. POTS is a syndrome and not a disease. It has an onset of symptoms that start after stress to the immune system through viral or bacterial infection, trauma, pregnancy, surgery, vaccination, or psychosocial stress. There are multiple aetiologies when reviewing POTS, but the main theories from the literature include hypovolemia, neuropathic hyperadrenergic activation, an autoimmune disorder, increased sympathetic activity, and partial autonomic neuropathy. The standard testing protocol involves the use of a tilt-table test to determine a patient's orthostatic tachycardia and intolerance. The long-term prognosis of POTS is not well known, and some patients undergo radical recovery in a couple of years post-diagnosis. Others experience deconditioning or an improvement or worsening of symptoms during pregnancy. After diagnosis, patients are informed about nonpharmacological and pharmacological treatment options that can alleviate their symptoms. Current pharmacological measures' overall effect is modest and attempts to control heart rate, vasoconstriction, and increase intravascular volume. However, most patients remain disabled even with an assortment of medications. Nonpharmacological options include lifestyle changes of changing daily habits, changing how to exercise, adding in supportive attire like compression stockings. Quality of life generally increases after receiving a diagnosis and undergoing treatments. Nonpharmacological treatments are preferred because they are proven to be as effective as pharmaceutical medications. POTS is debilitating, but certain symptoms can be successfully treated with a proper diagnosis and treatment plan.
Keywords:
postural orthostatic tachycardia syndrome, POTS, tachycardia, tachyarrhythmia, heart rate
Department
Biology
College
College of Science and Engineering
Included in
Clinical Overview of Postural Orthostatic Tachycardia Syndrome (POTS)
Postural Orthostatic Tachycardia Syndrome, POTS, is a syndrome of the cardiovascular autonomic system with characteristic symptoms of tachycardia and orthostatic intolerance upon standing. The most commonly seen symptoms in-clinic include weakness, dizziness, rapid heartbeat, and palpitations upon standing. Other symptoms often reported but not prevalent for every patient are reduced exercise capacity, deconditioning, gastrointestinal disorders, dyspnea, gastrointestinal disorders, and brain fog. POTS affects mainly women (80%) of child-bearing years from ages 10-45. POTS has a 0.2 – 1.0% prevalence in developing countries. POTS is a syndrome and not a disease. It has an onset of symptoms that start after stress to the immune system through viral or bacterial infection, trauma, pregnancy, surgery, vaccination, or psychosocial stress. There are multiple aetiologies when reviewing POTS, but the main theories from the literature include hypovolemia, neuropathic hyperadrenergic activation, an autoimmune disorder, increased sympathetic activity, and partial autonomic neuropathy. The standard testing protocol involves the use of a tilt-table test to determine a patient's orthostatic tachycardia and intolerance. The long-term prognosis of POTS is not well known, and some patients undergo radical recovery in a couple of years post-diagnosis. Others experience deconditioning or an improvement or worsening of symptoms during pregnancy. After diagnosis, patients are informed about nonpharmacological and pharmacological treatment options that can alleviate their symptoms. Current pharmacological measures' overall effect is modest and attempts to control heart rate, vasoconstriction, and increase intravascular volume. However, most patients remain disabled even with an assortment of medications. Nonpharmacological options include lifestyle changes of changing daily habits, changing how to exercise, adding in supportive attire like compression stockings. Quality of life generally increases after receiving a diagnosis and undergoing treatments. Nonpharmacological treatments are preferred because they are proven to be as effective as pharmaceutical medications. POTS is debilitating, but certain symptoms can be successfully treated with a proper diagnosis and treatment plan.
