Is my chest tightness linked to POTS?

Question

Hello doctor,

I am having what I believe to be POTS symptoms. When standing up, most of the time I get a tightness in my chest; sometimes I lose vision, it gets hard to breathe, I get lightheaded, and my tinnitus gets worse.

Everything lasts for the next few seconds. Even just looking up with my arms above my head makes it hard for me to breathe, and I get lightheaded. From what I could see from my watch, my heart rate jumped from something in the 80s to 123.

I walk a lot each day, so I get exercise and drink a lot of water and eat salt, and I'm a teen, and my parents won't listen to me. My symptoms have been occurring for about three to four years now.

Kindly help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and can understand your concern.

What you are describing does line up with symptoms seen in conditions like postural orthostatic tachycardia syndrome, where standing causes a jump in heart rate along with lightheadedness, vision changes, chest discomfort, and breathing difficulty.

The increase you noticed from the 80s to around 123 when upright is in the range doctors look at, especially in teens, and the fact that it has been happening consistently for years, makes it important to take it seriously.

The arm raising and looking up triggering symptoms could also suggest issues with blood flow or autonomic regulation, and your mention of possible hypermobile Ehlers-Danlos syndrome is relevant because it can be associated with similar symptoms. That said, chest tightness and shortness of breath are not things to ignore or self-diagnose, because other conditions involving the heart, lungs, or circulation can overlap with this and need to be ruled out.

Even if your parents are hesitant, you still deserve medical attention for something that affects your daily life like this. If you can, try to clearly document your symptoms, including heart rate changes when lying down versus standing, how long symptoms last, and what triggers them, and show that to a doctor, school nurse, or another trusted adult.

If you ever have severe chest pain, fainting, or trouble breathing that does not quickly pass, that should be treated as urgent. In the meantime, simple measures like rising slowly, avoiding locking your knees when standing, and continuing hydration and salt intake may help somewhat, but they are not a substitute for evaluation

I hope this helps.

Thank you and take care.

Regards.