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Postural Orthostatic Tachycardia Syndrome (PoTS)

What is Postural Orthostatic Tachycardia Syndrome?

Postural tachycardia syndrome (PoTS) is when the heart rate increases abnormally, occurring after sitting up or standing. Whilst it affects various types of people, it is most common in girls and women 15 to 50 years old.

Sitting up or standing pulls the blood down to your lower abdominal area, hands and feet. In doing so the blood vessels narrow quickly and your heart rate increases to maintain blood flow to the brain and heart. It is your autonomic nervous system that does this without thinking.

Those with PoTS have an autonomic nervous system that doesn’t work properly, so when there is a drop-in blood supply to the heart and brain when sitting up or standing, the heart races to compensate for this.

What causes Postural Orthostatic Tachycardia Syndrome?

The most common cause of PoTS is when people have a problem with their nervous system. It can develop suddenly after a viral illness or traumatic event. Other known causes include:

  • Joint hypermobility syndrome – unusually flexible joints and abnormally elastic blood vessels
  • Conditions such as diabetes amyloidosis, sarcoidosis, lupus, Sjogren’s syndrome, or cancer
  • Alcohol or metal poisoning
  • Inheriting faulty genes

Symptoms of Postural Orthostatic Tachycardia Syndrome

PoTS can come on suddenly or can gradually develop over time but symptoms usually appear with a few minutes of sitting up or standing. These symptoms include:

Some women find symptoms are worse when they are on their period.

heartbeat print

Testing for Postural Orthostatic Tachycardia Syndrome

If your heart rate increases by 30 beats per minute or more after 10 minutes of standing, PoTS will likely be diagnosed. And whilst self-care is usually the best course of treatment, the following tests are available to make a firm diagnosis:

  • The tilt table test – your heart rate and blood pressure are measured whilst lying on a bed, then the bed is tilted into an upright position whilst still measuring heart rate and blood pressure.
  • Active stand test – heart rate and blood pressure are measured after lying down, standing immediately, and after 2, 5 and 10 minutes.
  • An electrocardiogram (ECG)
  • An echocardiogram
  • 24-hour ambulatory blood pressure and heart rate monitoring
  • Blood test

Treating Postural Orthostatic Tachycardia Syndrome

PoTS requires specialist management.

  • Avoiding triggers- maintain hydration, avoid caffeine
  • Graded stockings
  • Medication
  • Pacemakers

Postural Orthostatic Tachycardia Syndrome Specialists

Our Heart Health specialists at OneWelbeck in London are leaders in their field. They are equipped with the latest diagnostic medical technology at custom-built, day-case facilities to investigate any symptoms and ensure you receive the best available care.

Contact Us

To speak with a specialist about Postural Orthostatic Tachycardia Syndrome, contact our team today.
We are available from Monday to Friday: 8am – 8pm.

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