Postural Tachycardia Syndrome (PoTS)

Key Points

Overview

Postural Tachycardia Syndrome (PoTS) is a condition where your heart beats much faster than normal when you move from sitting or lying down to standing. This rapid increase in heart rate can make you feel dizzy or lightheaded. The severity of PoTS varies greatly, impacting some people mildly and others significantly in their daily lives. The exact cause of PoTS is not fully understood, and it can develop suddenly or gradually. While there is no cure, the condition can be effectively managed. Management typically involves making specific lifestyle adjustments and, in some cases, taking medication to control symptoms. Diagnosis can take time as PoTS symptoms often resemble those of other conditions. A doctor will usually check your heart rate and blood pressure when you stand up and may order further tests, including specialist evaluations, to confirm the diagnosis and rule out other causes.

Signs and Symptoms

• Dizziness or lightheadedness
• Noticeable heartbeats (palpitations)
• Chest pain
• Shortness of breath
• Shaking and sweating
• Fainting or nearly fainting
• Digestive problems (nausea, bloating)
• Headaches and vision problems
• Purple hands and feet
• Extreme tiredness (fatigue)
• Brain fog (thinking, memory issues)

Things That Increase the Risk

• Having Long COVID
• Myalgic encephalomyelitis (ME) or chronic fatigue syndrome (CFS)
• Joint hypermobility syndrome
• Being in hot places
• Standing or sitting upright for long periods
• Eating refined carbohydrates
• Not drinking enough fluids
• Consuming alcohol
• Resting too much
• Stress

Diagnosis

• GP checks blood pressure and heart rate before and after standing
• Blood tests
• Electrocardiogram (ECG)
• Referral to a specialist
• Urine tests
• 24-hour heart rate and blood pressure monitoring
• Tilt table test

Treatment & Management

• Drinking more fluids
• Eating small meals low in refined carbohydrates
• Wearing compression clothing
• Prescribed steroids
• Medications for heart conditions or blood pressure
• Selective serotonin reuptake inhibitors (SSRIs)
• Trying different medicine combinations
• Lying down and raising legs if faint
• Specific standing maneuvers (crossing legs, clenching muscles)

Prevention

• Avoid known triggers
• Stay well-hydrated
• Engage in gentle exercise (walking, Pilates, swimming)
• Raise the head of your bed
• Wear support tights
• Avoid standing for too long
• Stand up slowly after lying down
• Limit caffeine and alcohol intake

Related Diseases

• Low blood pressure
• Long COVID
• Myalgic encephalomyelitis (ME)
• Chronic fatigue syndrome (CFS)
• Joint hypermobility syndrome

Available Treatments

Explore our range of treatment options for Postural Tachycardia Syndrome (PoTS):