Postural Tachycardia Syndrome
Postural tachycardia syndrome (POTS) is a disorder characterized by a
pulse rate that is too fast when the patient stands.
Causes of POTS usually are not identified in individual patients. Reversible
causes such as low blood volume should be ruled out.
Symptoms include rapid heartbeat, lightheadedness with prolonged standing,
headache, chronic fatigue, chest pain, and other nonspecific complaints.
Treatment of POTS depends upon the severity of the symptoms. Individuals
with the disorder are usually advised to increase their fluid and salt intake.
Body stockings may provide some relief. Drug therapy, with fludrocortisone,
beta-blockers, midodrine, or clonidine, can be beneficial. Physical exercise,
especially calf muscle resistance training, also may help. Some patients
may require and benefit from insertion of a cardiac pacemaker.
The prognosis for individuals with POTS varies. Many patients improve
with treatment, although severe POTS can be disabling for years. The disorder
is not thought to progress to a cardiac disease.