Postural Orthostatic Tachycardia Syndrome (POTS)
- Curtis Allderidge
- Jun 10
- 2 min read
POTS is a condition that causes a significant increase in heart rate when a person goes from sitting to standing and is often associated with dizziness, light headedness, and palpitations. It is diagnosed via a significant increase in heart rate from sitting to standing in the absence of other causes such as hypotension (low blood pressure) or dehydration.
It is a type of dysautonomia (disorder of the autonomic nervous system). The autonomic nervous system is responsible for regulating involuntary physiological processes such as heart rate, blood pressure, body temperature, and digestion to name a few.
The pathophysiology behind POTS is not well understood but research suggests that physical deconditioning (poorer fitness), lower blood volume (reduced red blood cell and plasma volume), and reduced standing stroke volume may be some of the factors behind the condition.
There is also a strong association between POTS and hyper mobility disorders such as Ehlers-Danlos syndrome. There also appears to be an overlap between POTS, joint hypermobility and mast cell disorders.
Why do people with POTS get dizzy when they go from sitting to standing?
When we stand upright after sitting down, gravity pulls down on the blood in our lower limbs (legs). In a person without POTS, to make sure that enough blood reaches the brain, the body activates several key nervous system responses. One such response is that the body releases adrenaline when sitting to standing to vasoconstrict (tighten) the blood vessels and increase heart rate, to meet the new requirements on the body upon standing. Once the brain determines it has enough blood flow, the nervous system responses settle down back to normal.
In people with POTS, for reasons we don't fully understand, these responses do not occur. The blood vessels don't vasoconstrict and as a result, more blood remains in the lower half of their body so when they stand upright they become dizzy, experience light-headedness, and fatigue. Their heart rate continues to elevate in an attempt for enough blood to reach the brain which can even be felt as heart palpitations and chest pain.
The Australian POTS foundation says that there are currently no POTS-specific medications available on the PBS (Pharmaceutical Benefits Scheme) that can assist with the managing the complex chronic condition. Fortunately, Exercise is an effective method for managing POTS symptoms when guided by an Allied Health Professional such as an Exercise Physiologist.
Because people with POTS have reduced stroke volume (amount of blood pumped out of the hearts left ventricle with each contraction) and decreased blood volume, we know exercise can significantly help these two variables as well as many other benefits!
In fact, exercise can help so much that studies have shown that after 3-months of completing supervised exercise sessions, it can reduce the symptoms so much that a person may no longer meet the criteria for a POTS diagnosis!
For any further information, questions, or to book an appointment please feel free to contact me via phone (03) 8203 2814 or email curtis@conqueralliedhealth.com.au
"Conquer Your Pain, Injury, and Health."
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