Suffering from Postural Orthostatic Tachycardia Syndrome?

November 12, 2012

Suffering from Postural Orthostatic Tachycardia Syndrome?

Have you ever sat up quickly and realized that you felt “off” afterwards. Postural orthostatic tachycardia syndrome affects many people who may not realize medical help should be sought.

Postural orthostatic tachycardia syndrome has been known since around the 1940s. It can be a disabling condition because it affects the ability of a person to safely move into an upright position. The body must have an effective circulatory system and intact neurological compensations that are able to react rapidly from one body position to the next. POTS occurs when the body, for whatever reason, is unable to adequately regulate blood pressure while also maintaining consciousness. While some people may have slight day to day problems associated with the diseased state, others are unable to go to school or hold a job. If a person feels they may have POTS, a healthcare professional should be contacted for personalized treatment options.

Symptoms

The signs and symptoms of postural orthostatic problems are most noticeable when a person sits or stands up after being in a supine position. The inability of blood to correctly shift throughout the body causes a number of effects including:

  • A rapid increase in heartache within ten minutes of the position change. It can range from 30-120 more beats per minute.

  • Onset of nausea

  • Fatigue

  • Dizziness

  • Heart palpitations

  • A decrease in blood pressure known as hypotension

  • A feeling of overheating

  • Difficulty in focusing or concentrating immediately after the position change

Many of the symptoms are a result of the sudden shift in blood pressure that occurs with postural orthostatic tachycardia syndrome. They often fade within a few minutes as long as the body is able to adequately adjust to the changes. People experiencing these effects should wait until their body has fully adjusted before attempting to perform vigorous physical activity which could result in further complications.

What Causes It?

Postural orthostatic problems are common among the general population. At this point in time, there is no set cause for the syndrome but there are common links between patients. Almost everyone affected is female. Women make up about 80% of all people suffering from the condition. The average age range is 12-50 years old with an increasing prevalence in adolescents. Individuals with a high resting heart rate have a tendency to develop or currently be suffering from the tachycardia syndrome. Current research has shown that anxiety may have an effect on the development of postural orthostatic tachycardia condition. There seems to be an overlap between this condition and panic/anxiety disorders which suggest that anxiety and stress effects on the body can lead to more problems. Chronic fatigue syndrome seems to have a link with orthostatic conditions. There is evidence that suggests POTS is responsible for many of the orthostatic intolerance symptoms associated with CFS.

Possible Pathophysiology

Hypotension is a main symptom of postural orthostatic tachycardia syndrome. The main reason for this is because there seems to be small venous and arterial changes within the body which results in the pooling of fluids in the lower extremities. This pooling is mainly due to gravity as the body is not able to efficiently move the fluid make up the body. Compression of the lower body and saline overloading results in a temporary correction of the orthostatic problems. In order to efficiently treat the disease condition, it is important for medical professionals to fully understand what is causing the problem. There are currently a few theories on why the body allows the pooling to occur:

  • Autonomic neuropathy of the lower limbs resulting in alpha 1 adrenergic nerve problems

  • Decreased sensitivity of alpha 1 receptors

  • Altered venous constriction in the extremities

  • Problems with capillary filtration

  • Increased sensitivity of beta 1 receptors

There is controversy present for every proposed method. Future research will help to narrow down the exact causes so that better treatment plans can be implemented.

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