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Could Your Dizziness Be Postural Orthostatic Tachycardia Syndrome (POTS)?

Have you ever slept through your alarm? You wake up with your heart racing. You jump out of bed and run to get ready. We’ve all had that moment of panic and rush of adrenaline.

Most of us don’t think twice when we stand up (or jump out of bed quickly). Yet for those with a disorder called postural orthostatic tachycardia syndrome (POTS), springing out of bed or even standing upright can leave them feeling dizzy, or worse, it can cause them to faint.

If you’re experiencing dizzying symptoms or fainting spells when you stand up, read on to learn more about postural orthostatic tachycardia syndrome.

What is postural orthostatic tachycardia syndrome (POTS)?

POTS is a disorder that can make someone feel faint or dizzy. POTS occurs when your body doesn’t adjust in the way it should to standing or sitting up after lying down. Your heart rate rises faster than it should due to problems with your autonomic nervous system, the system responsible for controlling your heart rate, blood pressure and breathing.

“Normally, when you stand from a seated or lying position, the blood vessels in the lower part of your body (or legs) will narrow and push blood quickly back to the heart and the brain,” said I-Hui Ann Chiang, MD, an interventional cardiologist with Banner – University Medicine Cardiology Clinic. “Because of this normal response, there is little change in heart rate with changes in position.”

With POTS, however, the autonomic nervous system doesn’t work in the usual way, so your blood vessels don’t tighten enough to make sure there’s enough blood flow to your brain. “This causes the heart to respond by increasing your heart rate to maintain blood flow to the brain, making you feel dizzy or faint.” Dr. Chiang said.

What are the symptoms of POTS?

While the main symptom of POTS is an increased heart rate after standing, many other symptoms have been linked to the condition, including:

  • Dizziness or lightheadedness
  • Fainting or near fainting
  • Exercise intolerance
  • High or low blood pressure
  • High or low heart rate
  • Headaches
  • Insomnia
  • Chest pain
  • Abdominal pain
  • Forgetfulness or brain fog

What causes POTS?

There are lots of conditions that can cause the same symptoms as POTS, so it’s important to see your health care provider if you’re feeling dizzy or are fainting. POTS can be triggered by a viral illness or pregnancy, but POTS has also been linked to some medical conditions, such as Ehlers-Danlos syndrome, Sjogren’s syndrome and COVID-19.

“There’s some limited data that patients with long COVID may also suffer from POTS-like symptoms but because of the relative newness of this disease process, it is not completely understood,” Dr. Chiang said.

Other health problems linked to POTS include impaired nerve function, poor blood circulation and blood pressure.

How is POTS diagnosed?

There’s no single test to diagnose POTS, but your health care provider will start with a complete physical exam and review your medical history. In addition, they may run several tests, including an echocardiogram, cardiopulmonary testing, a stand test and a tilt table test.

“A tilt table test is the gold standard test for diagnosis but it’s not readily available at most facilities,” Dr. Chiang said. “In this test, you’re strapped to a table, then tilted from lying on your back into an upright position (standing) while your heart rate and blood pressure are measured.”

How is POTS treated?

POTS is a chronic health condition, but it can get better on its own or with treatment. POTS treatment may involve the following:

  • Take medications: Certain medications, including beta blockers, salt tablets, fludrocortisone, midodrine and pyridostigmine, can help treat symptoms.
  • Wear compression garments: Wear knee-high compression stockings or footless calf sleeves, leggings and bike shorts to help keep your blood circulating well.
  • Gradually increase exercise: Work with a physical therapist to learn what types of physical activity you can do, then slowly work up from there.
  • Hydrate: Drink at least two to three liters of water (8 to 12 cups). Increase your salt intake to at least 3,000 to 10,000 milligrams per day to maintain blood volume.
  • Eat small meals: Eat small, frequent meals throughout the day and try to avoid or cut down on alcohol and caffeine as these can make symptoms worse.

What’s the outlook for people with POTS?

Most people notice their symptoms get better with medication and lifestyle changes and/or symptoms improve over time. If you find your symptoms aren’t getting better or they’re affecting your daily life, schedule an appointment with your health care provider.

To find a Banner Health specialist near you, visit bannerhealth.com.

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