Postural orthostatic tachycardia syndrome, also known as PoTS, is a relatively unknown but common condition affecting the autonomic nervous system (the blood pressure control system), causing an increase in heart rate on standing. It tends to affect younger women in particular although not exclusively. It can produce a range of heart symptoms which include dizziness and blackouts, palpitations, breathlessness and chest pain.
The condition can also be associated with hypermobility (high range of joint movement) which can cause joint discomfort or pain. Fatigue is often a prominent feature and it is estimated that up to 40% of chronic fatigue syndrome (ME) sufferers may have PoTS. PoTS can affect various parts of the body including the bowels with irritable bowel-type presentations, the bladder with frequency, incontinence and infection, as well as causing migraines and disturbed sleep patterns, amongst others. Over more than a decade we have developed an expertise in this area, in its investigation and management.
Tests that might be required from the cardiological perspective include tilt testing or an active stand, Echocardiography (ECG), heart rate monitoring and exercise testing. The management of PoTS is complex; hence our holistic approach in combining non-medical treatments such as lifestyle changes (increasing fluid and salt intake, exercise and diet), as well as medications including Midodrine and Ivabradine.
We work with a range of experts to treat all aspects of the condition including rheumatology, gastroenterology, urology, physiotherapy, endocrinology and neurology depending on symptoms. For more information about this condition please visit www.potsuk.org and www.heartrhythmalliance.org/stars/uk.