Learning About Postural Orthostatic Tachycardia Syndrome (POTS)

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What is POTS?

Postural orthostatic tachycardia syndrome (POTS) is a fast heart rate (tachycardia) that starts after you stand up. This can cause symptoms such as dizziness or weakness.

What happens when you have POTS?

With POTS, the body does not control the heart rate as it should after you stand up. The change in heart rate happens within 10 minutes of standing up. This leads to symptoms such as dizziness, palpitations, trembling, or weakness. It's not known exactly why symptoms happen.

People with severe symptoms may find it hard to keep up with daily living. But treatment can help.

What are the symptoms?

Soon after you stand up, you may have symptoms such as:

  • A fast, pounding heartbeat (palpitations).
  • Trembling, dizziness, weakness, or lightheadedness.
  • Feeling faint or very tired.

With POTS, you may also have problems with:

  • Blurred vision, headaches, nausea, and diarrhea.
  • Trouble sleeping and feeling anxious.
  • Keeping your attention focused.

Symptoms can range from mild to severe.

Some things can make symptoms worse. These include heat, menstrual cycle, dehydration, alcohol, exercise, and standing for a long time.

When you first notice symptoms, lying down may help you feel better.

What causes it?

Experts don't understand what causes it, but different body systems seem to be out of balance. POTS may follow certain triggers such as a viral illness, a surgery, or pregnancy.

How is POTS diagnosed?

To learn what is causing your symptoms, your doctor may:

  • Ask about your symptoms, including when and how they started.
  • Check how your blood pressure and heart rate change when you move from lying down to sitting to standing.
  • Do blood tests.
  • Check your heart with an electrocardiogram (EKG).

You may have other tests such as a tilt table test. This test checks how your body responds when you change positions.

How is POTS treated?

Work with your doctor to find the right mix of treatments to help relieve symptoms and improve your quality of life. These treatments may include:

  • Taking medicine prescribed by your doctor. For some people, taking medicine that affects blood pressure can help. Taking medicine that keeps the body's fluids balanced may also help.
  • Everyday self-care. These practices can be a key part of helping the body get back in balance.
    • Drink plenty of fluids. For many people, low body fluid is part of what makes POTS symptoms worse.
    • Eat the amount of salt your doctor tells you to. Salt helps keep up the body's fluid level.
    • Try a special exercise program. Your doctor may give you a program of specific exercises. You might start short and slow, especially if fatigue is a problem. Then you can add a little at a time. At first, you may only do exercise when you're reclined. Or you may try swimming. After a while, you start to add upright exercise.
    • Wear compression stockings if your doctor recommends them.
    • Keep track of your symptoms and what makes them better and worse.

When should you call for help?

Call 911 anytime you think you may need emergency care. For example, call if:

  • You passed out (lost consciousness), and it feels different than your typical episode or you don't recover as quickly as you have in the past.

Call your doctor now or seek immediate medical care if:

  • Your symptoms are getting worse. For example, you are more dizzy or lightheaded.

Watch closely for changes in your health, and be sure to contact your doctor if:

  • You do not get better as expected.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

Where can you learn more?

Go to https://www.healthwise.net/patientEd

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The Health Encyclopedia contains general health information. Not all treatments or services described are covered benefits for Kaiser Permanente members or offered as services by Kaiser Permanente. For a list of covered benefits, please refer to your Evidence of Coverage or Summary Plan Description. For recommended treatments, please consult with your health care provider.