Postural orthostatic tachycardia syndrome (patient information)

Postural orthostatic tachycardia syndrome
Overview
What are the symptoms?
What are the causes?
Who is at highest risk?
Diagnosis
When to seek urgent medical care?
Treatment options
Where to find medical care for Postural orthostatic tachycardia syndrome?
Prevention
What to expect (Outlook/Prognosis)?
Possible complications
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Assistant-Editor-In-Chief: Meagan E. Doherty

Overview

Postural orthostatic tachycardia syndrome is a condition in which when a person transitions from a supine (lying down) position to standing upright there is an insufficient amount of blood that returns back to the heart due to poor circulation. This lack of blood traveling back to the heart causes an immediate decrease in blood pressure and an increase in heart rate which could lead to lightheadedness, fainting, and extreme fatigue.

What are the symptoms of Postural orthostatic tachycardia syndrome?

Symptoms of Postural orthostatic tachycardia syndrome can include:

• Increase in heart rate from supine to upright position of more than 30bpm or to a heart rate of 120 bpm within 10 minutes of standing
• Decrease in blood pressure which can lead to:
  • Lightheadedness
  • Syncope (fainting)
  • Exercise intolerance
  • Fatigue
• Poor blood flow to the organs and upper parts of the body which can lead to:
  • Cold hands
  • Chest pain
  • Muscle weakness
  • Shortness of breath
  • Headache
  • Vision problems
  • Brain fog
  • Depression
  • Anomia (word finding problems)
  • Difficulty concentrating
  • Difficulty sleeping
• Gastrointestinal symptoms
  • Stomach pain
  • Constipation
  • Diarrhea
  • Bloating
  • Nausea
  • Vomiting
• Inappropriate levels of hormones
  • Chills
  • Fear
  • Sweating
  • Feeling nervous

What are the causes of Postural orthostatic tachycardia syndrome?

The cause of Postural orthostatic tachycardia syndrome remains unknown. However, most people develop POTS in their teenage years and see a gradual improvement in their mid-twenties. Others develop Postural orthostatic tachycardia syndrome after:

• Viral infections
• Bacterial infections
• Mononucleosis
• Pneumonia
• Trauma or injury
• After or during pregnancy

The causes of POTS are not fully known. Most patients develop symptoms in their teenage years during a period of rapid growth and see gradual improvement into their mid-twenties. Others develop POTS after a viral or bacterial infection such as mononucleosis or pneumonia. Some patients develop symptoms after experiencing some sort of trauma such as a car accident or injury. Women can also develop POTS during or after pregnancy. These patients generally have a poorer prognosis. In one large test, 12.5% of 152 patients with POTS reported a family history of orthostatic intolerance, suggesting that there is a genetic inheritance associated with POTS.

Where to find medical care for Postural orthostatic tachycardia syndrome?

Directions to Hospitals Treating Postural orthostatic tachycardia syndrome