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Postural orthostatic tachycardia syndrome (POTS)

Overview

Postural orthostatic tachycardia syndrome (POTS) is a condition that affects how the body regulates blood flow and heart rate when moving from lying down to standing. In people with POTS, standing causes the heart to beat much faster than normal because not enough blood returns to the heart and brain.

Research suggests immune system involvement in some individuals, and many people with POTS also have autoimmune diseases, but no single autoimmune cause has been identified.

There are multiple variations of POTS, which include:

Neuropathic POTS
associated with damage to small-fiber nerves, which results in blood pooling in the lower extremities.
Hyperadrenergic POTS
associated with overactivity of the sympathetic nervous system, which is involved in the body’s response to threatening situations.
Low blood volume POTS
associated with low levels of blood which can cause similar symptoms overlapping neuropathic and hyperadrenergic POTS.
Secondary POTS
associated with another condition, which is known to cause or contribute to POTS symptoms.

Common Symptoms

Dizziness/lightheadedness, fainting, high or low blood pressure, chest pain, abdominal pain, brain fog (trouble concentrating and cognitive dysfunction), headaches, insomnia, heart palpitations, fatigue, excessive sweating, and nausea.

Coexisting Diseases and Conditions

Lyme disease, systemic lupus erythematosus, Sjogren’s syndrome, scleroderma, complex regional pain syndrome, sarcoidosis, antiphospholipid syndrome, autoimmune autonomic ganglionopathy, multiple sclerosis, type 1 diabetes, and Ehlers-Danlos syndrome.

Risk Factors and Prevalence

POTS is most common among females between the ages of 15 and 45 years old. Specific gene polymorphisms have also been reported to be associated with the syndrome. Viral illnesses, infections, pregnancy, and trauma are other risk factors.

Recent Research

Sources

  1. Article Sources

    1. Dysautonomia International: Postural Orthostatic Tachycardia Syndrome. (n.d.). Retrieved July 27, 2021, from http://www.dysautonomiainternational.org/page.php?ID=30

    2. Gunning, W. T., Kvale, H., Kramer, P. M., Karabin, B. L., & Grubb, B. P. (2019). Postural Orthostatic Tachycardia Syndrome Is Associated With Elevated GProtein Coupled Receptor Autoantibodies. Journal of the American Heart Association, 8(18), e013602. https://doi.org/10.1161/JAHA.119.013602

    3. Postural Orthostatic Tachycardia Syndrome (POTS). (n.d.). Retrieved July 27, 2021, from https://www.hopkinsmedicine.org/health/conditions-and-diseases/postural-orthostatic-tachycardia-syndrome-pots

    4. Postural Tachycardia Syndrome Information Page | National Institute of Neurological Disorders and Stroke. (n.d.). Retrieved July 27, 2021, from https://www.ninds.nih.gov/Disorders/All-Disorders/Postural-Tachycardia-Syndrome-Information-Page

    5. Postural tachycardia syndrome (PoTS). (2017, October 19). Nhs.Uk. https://www.nhs.uk/conditions/postural-tachycardia-syndrome/

    6. POTS: Causes, Symptoms, Diagnosis & Treatment. (n.d.). Cleveland Clinic. Retrieved July 27, 2021, from https://my.clevelandclinic.org/health/diseases/16560-postural-orthostatic-tachycardia-syndrome-pots

    7. Aboseif, A., Bireley, J. D., Li, Y., Polston, D., & Abbatemarco, J. R. (2023). Autoimmunity and postural orthostatic tachycardia syndrome: Implications in diagnosis and management. Cleveland Clinic journal of medicine, 90(7), 439–447. https://doi.org/10.3949/ccjm.90a.22093