What’s POTS?

POTS is a type of dysautonomia — a disorder of the autonomic nervous system. This branch of the nervous system regulates capabilities we don’t consciously control, equivalent to coronary heart rate, blood pressure, sweating and body temperature. The key characteristics of POTS are the precise symptoms and the exaggerated increase in heart rate when standing.

What does POTS stand for?

Postural: associated to the position of your body

Orthostatic: associated to standing upright

Tachycardia: elevated heart rate

Syndrome: a group of symptoms

Why does heart rate enhance excessively with POTS?

In most patients with POTS, the construction of the guts itself is normal. POTS symptoms arise from a mix of the following:

Decrease quantity of blood in the circulation

Extreme pooling of blood beneath the level of the center when upright

Elevated levels of certain hormones corresponding to epinephrine (also known as adrenaline since it is launched by the adrenal glands) and norepinephrine (primarily released by nerves).

After we stand, gravity pulls more blood into the lower half of the body. In a healthy person, to make sure that a enough amount of blood reaches the brain, the body prompts a number of nervous system responses. One such response is releasing hormones that help tighten blood vessels and cause a modest increase in coronary heart rate. This leads to better blood flow to the guts and brain. Once the brain is receiving enough blood and oxygen, these nervous system responses settle back to normal.

In individuals with POTS, for unclear reasons that may differ from individual to individual, the blood vessels don’t respond effectively to the signal to tighten. In consequence, the longer you are upright, the more blood pools within the lower half of your body. This leads to not sufficient blood returning to the brain, which could be felt as lightheadedness (faintness), brain fog and fatigue. Because the nervous system continues to release epinephrine and norepinephrine to tighten the blood vessels, the heart rate will increase further. This may cause shakiness, forceful or skipped heartbeats, and chest pain.

Some people with POTS can develop hypotension (a drop in blood pressure) with prolonged standing (more than three minutes upright). Others can develop an increase in blood pressure (hypertension) when they stand.

Types and Causes of POTS

The causes of POTS fluctuate from individual to person. Researchers don’t solely understand the origins of this disorder. The classification of POTS is the topic of dialogue, however most authorities recognize different traits in POTS, which occur in some patients more than others. Importantly, these characteristics will not be mutually unique; individual with POTS could expertise more than of these at the identical time:

Neuropathic POTS is a time period used to describe POTS related with damage to the small fiber nerves (small-fiber neuropathy). These nerves regulate the constriction of the blood vessels in the limbs and abdomen.

Hyperadrenergic POTS is a time period used to describe POTS related with elevated levels of the stress hormone norepinephrine.

Hypovolemic POTS is a term used to explain POTS associated with abnormally low levels of blood (hypovolemia).

Secondary POTS implies that POTS is associated with another condition known to potentially cause autonomic neuropathy, corresponding to diabetes, Lyme disease, or autoimmune problems such as lupus or Sjögren’s syndrome.

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