Postural Orthostatic Tachycardia Syndrome (POTS) is a disorder of the autonomic nervous system that affects blood flow regulation. People with POTS experience a significant increase in heart rate when moving from lying down to standing, often accompanied by dizziness, fatigue, and other symptoms. While it can impact anyone, it most commonly affects women between the ages of 15 and 50.
At Oly Heart & Vascular Institute, our cardiology and autonomic testing services are designed to help diagnose and manage conditions like POTS, empowering patients to regain control of their daily lives.
What Happens in POTS?
Normally, when you stand up, your body’s autonomic nervous system adjusts your heart rate and blood vessel tone to maintain stable blood pressure and blood flow to the brain.
In POTS, this regulation is impaired, leading to:
- A heart rate increase of 30 beats per minute or more (or above 120 bpm) within 10 minutes of standing
- Often without a significant drop in blood pressure
- Symptoms triggered or worsened by prolonged standing, heat, dehydration, illness, or stress
Causes and Risk Factors
POTS can occur on its own or as part of other conditions. Known causes and associations include:
- Viral or bacterial infections (post-viral POTS)
- Autoimmune disorders such as lupus or Sjögren’s syndrome
- Genetic factors affecting autonomic regulation
- Deconditioning after prolonged illness or inactivity
- Ehlers–Danlos syndrome and other connective tissue disorders
- Hormonal changes (often in women of childbearing age)
Common Symptoms of POTS
POTS symptoms can vary from mild to disabling and may include:
- Rapid heartbeat upon standing
- Lightheadedness or dizziness
- Fatigue and “brain fog”
- Headaches
- Nausea
- Exercise intolerance
- Palpitations
- Visual changes (blurred vision, tunnel vision)
- Fainting or near-fainting episodes
Diagnosis of POTS
At Oly Heart, we use a detailed medical history, physical examination, and specialized testing to confirm a POTS diagnosis. This may include:
- Tilt Table Testing
- Heart rate and blood pressure monitoring
- Autonomic reflex testing
- Blood volume and catecholamine studies
Treatment and Management
While there is no single cure for POTS, many patients experience significant improvement with a combination of strategies:
Lifestyle Adjustments
- Increased fluid intake (2–3 liters/day)
- Higher salt diet (as recommended by your provider)
- Compression stockings to improve blood flow
- Gradual, recumbent exercise program to recondition the heart and muscles
- Avoiding triggers such as heat, prolonged standing, or dehydration
Medications
Depending on symptoms, your cardiologist may recommend:
- Beta-blockers to control heart rate
- Fludrocortisone to expand blood volume
- Midodrine to improve blood vessel tone
- Ivabradine or pyridostigmine in select cases
Prognosis
Many POTS patients see gradual improvement over time, especially with early diagnosis and a tailored treatment plan. While some individuals experience long-term symptoms, others recover fully within a few years, particularly after post-viral or post-surgical onset. Ongoing research continues to improve our understanding of POTS and its management.
Oly Heart & Vascular Institute: Helping You Stand Strong
Our expert cardiology team provides comprehensive autonomic evaluation and personalized treatment plans for patients with POTS and related conditions. We’re committed to helping you improve function, reduce symptoms, and restore quality of life.
📍 Location: 3620 Ensign Rd NE, Ste B, Olympia, WA 98506
📞 Schedule an appointment today to learn more about POTS and how we can help.
Oly Heart & Vascular Institute – Leading with Precision in Heart Health.