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Postural tachycardia syndrome (PoTS) is an abnormal increase in heart rate that occurs after sitting up or standing. Some typical symptoms include dizziness and fainting. 

Some people have mild symptoms, while others find the condition affects their quality of life. PoTS often improves gradually over time, and there are some medicines and self-care measures that can help. 

In the US, the total number of people with PoTS is estimated to be between 1 to 3 million. 

What causes PoTS and who can develop the syndrome?

The cause of the disorder is unknown. Anyone at any age can develop POTS, but it mainly affects women between the ages of 15 to 50 years of age. Some women report an increase in episodes of POTS right before their menstrual periods. 

POTS often begins after a pregnancy, major surgery, trauma, or a viral illness. It may make individuals unable to exercise because the activity brings on fainting spells or dizziness. 

What are the symptoms of PoTS?

Symptoms can include (but are not limited to) dizziness, lightheadedness, fainting, forgetfulness and trouble focusing, fatigue, intolerance of exercise, headache, blurry vision, heart palpitations or racing heart, excessive sweating, chest pain, tremor and nausea. 

How is it diagnosed?

A range of tests such as heart scans and blood tests  are required to rule out a number of other potential conditions. 

One of the tests to diagnose PoTS is the tilt table test. This test involves lying down in a specially designed table that gradually tilts until the person is in an upright position while medics measure their heart rate.

PoTS is diagnosed if the heart rate increases by 30 beats per minute above the normal resting level for that person for over 30 seconds alongside symptoms like dizziness or fainting. 

How is PoTS treated?

Treatment is targeted at relieving low blood volume or regulating circulatory problems that may cause the disorder. 

Simple interventions such as adding extra salt to the diet and attention to adequate fluid intake are often effective. Drugs to increase blood volume and narrow blood vessels are also commonly used. 

Drinking 16 ounces of water (two glasses) before getting up can also help raise blood pressure. 

Symptoms improved due to aerobic exercise like swimming, rowing or cycling in line with cardiac rehab programmes.

PoTS may follow a relapsing-remitting course, in which symptoms come and go, for years. In most cases, an individual with PoTS improves to some degree and becomes functional, although some residual symptoms are common. 

Sources: National Institute of Neurological Disorders and Stroke, Cleveland Clinic, Johns Hopkins Medicine