POTS: What do you need to know about this difficult-to-diagnose condition?

POTS is a complex disease with a range of symptoms affecting various body systems.

Postural orthostatic tachycardia syndrome (POTS) is a disorder characterized by an abnormal response of the cardiovascular system to changes in body position. When a person with POTS stands, most of the blood remains in the lower body, causing the heart rate to increase rapidly. POTS is a complex disease with a range of symptoms affecting various body systems. Diagnosis and management require a multidisciplinary approach, including medical, lifestyle and emotional interventions, to improve the quality of life of those affected by the disease.

What are its symptoms?

POTS can cause a variety of symptoms, including:

• dizziness or fainting
• blurred vision
• nausea and vomiting
• Gastrointestinal discomfort (abdominal pain, bloating, diarrhea, constipation)
• excessive sweating
• brain fog
• extreme fatigue
• Fluctuations in blood pressure and heart rate
• chest pain
• feeling hot or cold
• anxious or nervous
• shaking or trembling
• Headache, body aches, or neck pain
• Insomnia
• Abnormal color changes in the hands and feet

These symptoms often worsen during activities such as showering, standing in line, or being stressed. Additionally, POTS symptoms may be triggered after eating because digestion requires increased intestinal blood flow.

POTS type

• Neurogenic POTS: Related to damage to the small fiber nerves that control blood flow to the limbs and abdomen.
• Hyperadrenergic POTS: Characterized by higher levels of the stress hormone norepinephrine.
• Hypovolemic POTS: occurs when blood concentration in the body is abnormally low.

Causes and risk factors

Certain factors make individuals more susceptible to POTS, including:

Prevalence among women aged 15 to 50 years. Although no single gene has been found, a genetic link may exist. Associated with a variety of conditions, such as anemia, autoimmune diseases (such as Sjogren’s syndrome or lupus), chronic fatigue syndrome, diabetes, Ehlers-Danlos syndrome, infectious diseases (mononucleosis, Lyme disease , hepatitis C), multiple sclerosis, and click murmur syndrome (mitral valve prolapse). POTS can also occur after a serious infection, pregnancy, or head injury.

diagnosis

Diagnosing POTS can be challenging because of the variety of symptoms of POTS. The tilt table test is a commonly used diagnostic method. In this test, patients lie on a table that is slowly tilted upright to simulate standing while their heart rate changes are monitored. It is important to work with an expert who is familiar with POTS. Other tests may include urine tests, blood tests, electrocardiogram, echocardiogram, quantitative sudomotor axon reflex test (QSART), Valsalva maneuver, and cutaneous nerve biopsy.

treat

Although there is no cure for POTS, a variety of treatments can help manage its symptoms:

1. Medications: Your doctor may prescribe medications such as fludrocortisone, midodrine, phenylephrine, or beta-blockers to improve blood flow and regulate symptoms.
2. Compression stockings: These can help push blood away from the legs and back to the heart.
3. Diet: Consuming more salt and fluids can help maintain blood volume.
4. Exercise: Light physical activity like walking or simple yoga can increase blood flow and support overall cardiovascular health.
5. Lifestyle modifications: Monitoring pulse and blood pressure, maintaining a consistent sleep schedule, and elevating the head of the bed can help with symptom management.
6. Emotional support: POTS can cause emotional stress, and support groups or therapy can help individuals cope with the psychological impact of the condition.