Postural Orthostatic Tachycardia Syndrome: Symptoms, Causes, Treatment

Symptoms may disrupt work or education despite normal heart structure. One high pulse or smartwatch reading is insufficient for diagnosis; POTS is not simply anxiety.

Related reading: Supraventricular tachycardia as a different cause of palpitations.

Standing can bring dizziness, palpitations, fatigue, brain fog, nausea, heat intolerance or near-fainting. Sitting or lying down often improves symptoms.

Autonomic regulation, circulation and blood volume can contribute. Symptoms may follow infection or accompany other disorders; no single cause explains every patient.

It is more common in females, teenagers and young adults and may accompany prior infection or joint hypermobility. These associations do not establish diagnosis or exclude other groups.

Heart rate and blood pressure are measured lying and standing at defined intervals, sometimes using tilt-table testing. Symptom duration, medicines, dehydration, anemia and thyroid disorders are assessed.

Individual plans may include compression garments, suitable rehabilitation and selected medicines. Increased fluid and salt requires medical guidance, particularly with heart or kidney disease or hypertension.

Falls, injury, activity limitation and reduced quality of life can result. Persistent fatigue or new symptoms warrants review of coexisting problems despite a previous diagnosis.

Rise gradually and limit prolonged standing, heat and personal triggers. Tailor activity to tolerance; report delayed deterioration after exertion rather than forcing exercise increases.