Postural Orthostatic Tachycardia Syndrome (POTS)

Postural tachycardia syndrome (PoTS) is an abnormal response by the autonomic nervous system to upright posture. It commonly causes a rapid increase in heart rate when moving from sitting or lying down to standing.

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Postural Orthostatic Tachycardia Syndrome (POTS)

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What is Postural Tachycardia Syndrome (PoTS)?

POTS is a circulatory disorder that causes the heart to beat unusually fast after standing up. The condition affects the autonomic nervous system, which controls important body functions such as heart rate, blood pressure, blood circulation, and temperature regulation.

When you stand up, your body normally adjusts blood flow and heart rate to maintain steady circulation to the brain and upper body. In people with POTS, this response does not work properly, causing the heart rate to rise quickly and leading to symptoms such as dizziness, palpitations, and fatigue. 

What Causes POTS?

POTS is a complex condition and can sometimes be mistaken for anxiety or other heart rhythm disorders because of its overlapping symptoms. In many cases, more than one factor may contribute to the condition. Common underlying causes and triggers include:

  • Autonomic nervous system dysfunction
  • Autoimmune conditions
  • Increased adrenergic activity
  • Dehydration
  • Strenuous physical activity
  • Viral or bacterial infection
  • Prolonged standing
  • Increase in body temperature due to a hot bath, shower, or warm weather. 

Symptoms of Postural Orthostatic Tachycardia Syndrome

Individuals suffering from Postural tachycardia syndrome may experience mild to severe symptoms that affect their quality of life. Usually, they appear in early adolescence between the ages of 15 and 50 years and are most common in women. Common symptoms include:

  • Persistent fatigue or low energy
  • Breathlessness
  • Rapid heartbeat or palpitations
  • Dizziness or light-headedness
  • Syncope/Fainting
  • Anxiety
  • Low Mood

Our Specialists’ Diagnostic Approach to POTS

Due to overlapping symptoms with many other health conditions, POTS often remains undiagnosed for years. Accurate diagnosis begins with a detailed assessment of your symptoms, medical history, family history, and a physical examination.

To confirm the diagnosis and rule out other possible causes, our specialists may recommend several heart investigations, including: 

During an active stand test, your heart rate and blood pressure are measured while lying down and again after standing for several minutes. A tilt table test works similarly by monitoring your cardiovascular response while your body is moved from a lying to a near vertical position.  A sudden spike in heart rate without lowering BP is one of the key findings to diagnose PoTS.

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Lifestyle Changes to Manage POTS Syndrome

Self-Management for Everyday Symptoms

  • Stay well-hydrated throughout the day
  • Avoid prolonged standing. If necessary, try shifting your weight between both legs or crossing your legs to improve circulation.
  • Elevate your head while sleeping
  • Avoid sudden changes in posture, especially moving quickly from lying to standing
  • Avoid hot showers/baths
  • Do regular exercise, especially calf muscle strengthening exercises, to support blood flow.

Self-Management for Acute Symptoms

If you suddenly feel dizzy or faint, take immediate steps to prevent complications.

  • Lie down flat and raise your legs if possible.
  • If lying down is not possible, simple movements such as rising onto your toes or tightening your stomach and leg muscles may help reduce symptoms. 

When to See a Cardiologist?

If you experience symptoms of POTS, it is important to consult a cardiology specialist for an accurate assessment and to rule out other conditions with similar symptoms. You should seek an urgent checkup if you experience dizziness, fainting, rapid heartbeat, breathlessness, or symptoms that worsen over time. 

Early diagnosis and specialist care can help identify the underlying cause of your symptoms and support effective long-term management.

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Why Choose The National Heart Clinic?

Our patients receive exceptional cardiac care from London’s top heart specialists. We combine advanced diagnostics, personalised treatment, and compassionate care to optimise your cardiovascular wellness. At The National Heart Clinic, you can expect:

  • Flexible appointments
  • Fast access to POTS treatment
  • Comprehensive heart diagnostics with State-of-the-art facilities

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Book an appointment with a POTS specialist for expert assessment, accurate diagnosis, and a personalised treatment plan. 

Faqs

Although POTS symptoms can be distressing and may affect daily life, the condition is not usually life-threatening and does not typically cause heart damage. With the right diagnosis and management plan, many people can successfully control their symptoms and improve their quality of life.

POTS can affect people of all ages and genders, but it is most commonly diagnosed in adults between the ages of 15 and 50. The condition is also more frequently seen in women than in men.

Some people may be at a higher risk of developing POTS following a serious illness, viral infection, physical trauma, pregnancy, or as a result of certain autoimmune conditions.

Regular physical activity and a structured exercise routine can play an important role in managing POTS symptoms. Gentle, supervised exercise programmes may help improve circulation, stamina, and symptom control.

Several conditions can cause symptoms similar to POTS, including Vasovagal Syncope, Inappropriate Sinus Tachycardia (IST), and anxiety-related disorders. Because of these overlapping symptoms, an accurate diagnosis requires a detailed assessment by an experienced specialist.

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