Postural Orthostatic Tachycardia Syndrome

Postural orthostatic tachycardia syndrome, or POTS, is a disorder that affects autonomic regulation resulting in an elevated heart rate with a normal blood pressure when standing. There are many symptoms of POTS, but most commonly include dizziness, lightheadedness, weakness, fatigue and blurry vision when standing.

A reduction in blood returning to the heart, a rapid increase in heart rate and the resulting lightheadedness define orthostatic intolerance, the primary symptom of POTS.

It’s estimated that four to five times more women than men experience POTS, most often in young women less than 45 years old.

POTS is a common condition with approximately 500,000 Americans living with it. Unfortunately, because symptoms can be so varied and nonspecific, there can often be a delay in diagnosis.

What Does POTS Mean?

Let’s take it word by word.

  • Postural, as in posture, refers to the position of your body.
  • Orthostatic is upright posture.
  • Tachycardia means a heart beat of more than 100 beats per minute..
  • Syndrome is a group of symptoms that, collectively, are identified with a disease or other disorder.

What Causes Postural Orthostatic Tachycardia Syndrome?

Researchers have yet to determine what, specifically, causes POTS, though it can be inherited or acquired, possibly due to a prior infection from a virus. Often the symptoms start suddenly, but they can also gradually appear over a period of time.
The disease causes irregularities in the autonomic nervous system, or ANS, which controls your heart rate, blood pressure and breathing. This system normally maintains proper blood pressure levels whether you’re standing, flat on your back or sitting. Bed rest and inactivity can cause cardiac atrophy of approximately 1% per week, increasing the risk for orthostatic intolerance.

Patients with POTS often feel frustrated because they are not able to do the normal things they used to without having symptoms. Sometimes, even simple things like getting dressed or walking their children to the school bus can be too difficult.

Symptoms of Postural Orthostatic Tachycardia Syndrome

Besides dizziness, lightheadedness, weakness, fatigue and blurry vision when standing , here are other possible signs of POTS:

  • Palpitations
  • Anxiety
  • Gastrointestinal symptoms, such as nausea or abdominal cramping
  • Loss of consciousness or syncope
  • Headaches
  • Mental fogginess

Diagnosing Postural Orthostatic Tachycardia Syndrome

As part of a complete physical exam, your doctor will monitor your blood pressure while you’re seated, reclined and standing. POTS increases your heart rate by greater than 30 beats per minute or higher than 120 beats per minute within 10 minutes of changing your body position without significant change to your blood pressure.

Your doctor might also order blood tests and possibly a tilt-table test. In this test, you’re secured to table that is moved to different positions and angles. Your heart rate and blood pressure are among the vital signs monitored during the test.

Treating Postural Orthostatic Tachycardia Syndrome

With no known definite cause of this chronic condition and symptoms that vary from patient to patient, your doctor usually tries to manage POTS with a combination of medication and changes in diet and exercise.

Because the symptoms and triggers for POTS are so varied from patient to patient, there is no “one size fits all” for treatment. It often takes several attempts to find a therapy that works for the patient, but eventually, most patients have improved symptoms by one year and many fully recover.

Some treatments that can help:

  • Drinking more water (up to 80 ounces a day)
  • Eating more salt in diet; sometimes even salt tablets are prescribed
  • Smaller meals supplemented by snacks
  • Exercise training, especially reclined aerobic exercise (such as a rowing machine). Swimming has also been found effective
  • Wearing compression stockings
  • Better, longer sleep
  • Raising the head of your bed (maintaining blood levels in the legs during sleep)
  • Medications
  • Intravenous saline infusions

Women’s Heart Wellness Program

The goal of the Women’s Heart Wellness Program is to provide comprehensive, personalized and compassionate care to women at risk for, and those living with heart disease.

Providers & Locations

Meet our Postural Orthostatic Tachycardia Syndrome Specialist:

Jeffrey Kluger


Cardiac Electrophysiology

Medical Group Hartford HealthCare Heart & Vascular Institute Wellness Center at Blue Back Square
West Hartford, CT 06107

Women’s Heart Wellness