Pots Syndrome - Causes, Symptoms, Diagnosis and Treatment

Introduction

Postural tachycardia syndrome; also called pots, is an atypical escalation in the heart rate and blood pressure that generally comes about right after standing up or sitting upright. The patient feels quite dizzy and may even faint. It is also referred to as orthostatic tachycardia syndrome. Thi syndrome is more common in young girls and women between the ages of 15 and 45. The symptoms are usually mild, but recurrent episodes may hamper the quality of life. Postural tachycardia syndrome can be reversed, and over time it even improves. Self-care and medication therapy are some measures that may help to some extent.

When an individual is sitting, gravity acts upon their blood and pulls it down to the hands, feet, and abdominal area. The reaction of this in the body is that the blood vessels narrow and slightly elevate the blood pressure in order to maintain a constant flow to the heart, brain, and the entire body. The ANS or autonomic nervous system efficiently controls this whole system. When this system malfunctions, the blood pressure drastically drops while standing, and the result is the brain and heart, racing to compensate for the blood loss.

What Are the Causes of Postural Tachycardia Syndrome?

It has been extensively studied that a malfunctioning of the autonomic nervous system is the root cause of long-term pots syndrome. Teenagers develop this but gradually overcome it with correct treatment and preventive measures.

Some of the known reasons are mentioned below.

• Pregnancy.

• Viral infection.

• Trauma.

• Chronic sickness.

• Hypermobile Ehlers-Danlos syndrome.

• Amyloidosis.

• Sarcoidosis.

• Lupus.

• Cancer.

• Sjogren’s syndrome.

• Diabetes mellitus.

• Metal poisoning.

• Alcohol overdose.

• Sudden adrenaline rush.

• Chronic fatigue syndrome.

• Head injury.

• Damage to nerve supply.

• Impaired blood vessels.

What Are the Signs and Symptoms of Postural Tachycardia Syndrome?

The development of postural tachycardia syndrome happens over a long period or may also occur in a short span. The clinical manifestations crop up immediately or may take several minutes after standing up. Promptly sitting down or resting the head may relieve the symptoms to some extent.

Mentioned below are some of the classical signs and symptoms of postural tachycardia syndrome.

• Lightheadedness.

• Fainting.

• Dizziness.

• Palpitations.

• Strong headache.

• Brain fog.

• Shortness of breath.

• Tremors.

• Shaking.

• Sweating.

• Weakness.

• Fatigue.

• Chest pain.

• Hot flashes.

• Numbness of some body parts.

• Abdominal cramp.

• Pain in the eyes.

• Difficulty in concentrating.

• Problems with memory and thinking.

• Panic attack.

• Anxiety.

• Irritation.

• Low blood pressure.

• Nausea.

• Pain above the nose.

• Feeling of sinusitis.

• Pain in one side of the head.

• Sudden neck stiffness or discomfort.

• Burning sensation in the body.

• Tingling sensation in the extremities.

• Stabbing sensation in the forehead.

• A feeling of the heart racing.

• Vomiting.

• Instability.

• Constipation.

• Diarrhea.

• Bloating.

• Blurred vision.

• Increased urinary output.

• Syncope.

• Heaviness in the lower limbs and sometimes upper limbs.

• Tremulousness.

How to Diagnose Postural Tachycardia Syndrome?

Palpating the heart rate and keeping track of the pulse is very important if there is a doubt of postural tachycardia syndrome. Within 10 minutes of standing, the blood pressure and pulse rate should be monitored. There is a range of diagnostic tools and tests in order to rule out the presence of postural tachycardia syndrome.

• A tilt table test is where the vital signs are monitored once the patient is asked to lie down.

• Active stand test is where the patient has their vital signs evaluated after immediately sitting upright or standing up.

• An electrocardiogram (ECG) helps to know the electrical activity of the heart.

• An ultrasound of the heart, such as an echocardiogram, is also helpful.

• A complete blood picture.

• Thyroid function test.

• Kidney functioning tests.

• Liver functions tests.

• Levels of glucose.

• Calcium levels in the blood.

How to Treat Postural Tachycardia Syndrome?

The best treatment for postural tachycardia syndrome is self-care. In case self-care does not show any significant changes in the syndrome, medications may need to be taken after consultation with a professional. It should be known that there is not a single medicine or an over-the-counter drug that will immediately solve an episode of postural tachycardia syndrome. An outbreak of postural tachycardia syndrome can be managed in the below-mentioned pattern.

• Lying down in case there is dizziness and a feeling of faintness.

• Raising the legs after lying down.

• Crossing the legs against each other while standing.

• Rocking on the toes.

• Clenching of the buttocks.

• Clenching of the abdominal muscles.

• Clenching of the fists.

• Drinking plenty of fluids.

• Closing the eyes and slowly opening them.

• Taking a deep breath from the nose.

• Focusing on one’s breathing pattern.

• Beta-blocker.

• Ivabradine.

• Midodrine.

• Fludrocortisone.

• Selective serotonin reuptake inhibitors.

How to Reduce the Episodes of Postural Tachycardia Syndrome?

The symptoms of postural tachycardia syndrome can be drastically reduced as well as prevented by bearing in mind some crucial points mentioned below:

• Drinking enough water.

• Staying active.

• Doing regular exercise.

• Swimming.

• Lower limb resistance band training.

• Regular walking.

• Pilates.

• Brisk walking.

• Jogging.

• Not sleeping flat.

• Avoid tight clothes.

• Avoiding compressed wear in the lower limbs.

• Avoiding long-standing.

• Slow rising up after sitting for a long time.

• Avoiding excess alcohol.

• Minimizing the intake of caffeine and caffeine-related beverages.

• Increasing the salt intake in the diet strictly after consultation with a cardiologist.

Conclusion

Pots or postural tachycardia syndrome is, also known as postural orthostatic tachycardia syndrome, is a condition that affects the flow of blood in the heart and brain. The symptoms develop immediately and include dizziness and an intense headache. The heartbeat increases with a feeling of the heart fluttering. Patients are advised to slowly stand up or slowly sit down in case they are known postural tachycardia syndrome patients. Self-care and focusing on measures to avoid the episodes of syncope followed by postural tachycardia syndrome is the way to go. The clinical manifestation is relieved by slowly sitting on or lying down straight. Postural tachycardia syndrome is a reversible condition and, once cured, will not affect the quality of life hereafter.