Postural orthostatic tachycardia syndrome (POTS) is a disease caused by the body's inability to react properly to a sudden change in posture. Usually, when a sick person gets up, they experience dizziness and a rapid rapid heart rate, accompanied by other variable symptoms. To diagnose the disorder, you will need to see your doctor so that they can examine your vital signs during position changes and evaluate for any other symptoms that may arise in the case of POTS.
Steps
Method 1 of 2: Recognize the Symptoms
Step 1. Recognize the signs and symptoms that accompany the syndrome
In addition to an elevated heart rate when standing, patients may present with various other symptoms, including:
- Unusual sense of exhaustion;
- Headache
- Dizziness and / or fainting;
- Exercise intolerance, with or without chest pain or shortness of breath;
- Heart palpitations (episodes of abnormal heart rhythm);
- Nausea and / or vomiting;
- Reduced ability to concentrate;
- Shaking and / or tremors
- Nervous system disorders affecting other parts of the body.
Step 2. Pay attention if you have recently had any problems that may have triggered a POTS episode
It is often an infection (such as mononucleosis), but other common factors include pregnancy and stress; however, the disease can also occur without obvious triggering conditions. Several studies have associated it with cardiovascular de-training.
Step 3. Know which categories are at risk
The individuals most likely to get POTS are women, people aged 12 to 50, and those who have been exposed to risk factors (such as an infection, pregnancy and / or stress); even those who take different types of drugs are more susceptible, because certain active ingredients for pressure and for the heart can aggravate and make the symptoms more evident.
Method 2 of 2: Get a Doctor Visit
Step 1. Bring the list of medications you are taking with you when you go to the doctor
When preparing for your appointment, it is important to have a list of medicines, stating the name, dosage and why you are taking them. You also need to be able to provide an accurate medical history of any surgery, hospitalization, or if you are currently suffering from any specific medical condition. All this information helps the doctor to get a complete picture of the situation, to evaluate the chances that you have contracted this syndrome and to decide whether to proceed with diagnostic tests.
Step 2. Let the doctor measure your heart rate in a standing and sitting position
POTS is a form of "autonomic dysfunction" (a pathology of the nervous system) and among the various symptoms you can notice moments of tachycardia when standing. In order to diagnose it, your doctor needs to evaluate your heart rate when you are sitting in a resting position and after you have been standing for a couple of minutes; if your heart rate increases by at least 30 bpm (beats per minute) when standing, you have this disease.
Step 3. Get your blood pressure measured too
After detecting the heart rate in the two different positions, the doctor also measures the pressure in order to exclude orthostatic hypotension, a disease that causes a sudden drop in pressure when you get up and that triggers, by compensation, a sudden acceleration of the cardiac activity. To make sure you don't diagnose POTS when you actually have orthostatic hypotension (i.e. blood pressure is the biggest problem, not heart rate), your doctor measures your blood pressure while you are sitting and then again when you are standing.
- If you are actually suffering from the syndrome and not from hypotension, your blood pressure does not drop significantly when you are in the two different positions.
- Alternatively, if your resting heart rate is around 120 bpm when you are standing, this in itself is a sign of POTS.
Step 4. Know that the criteria for evaluating heart rate are different for children and adolescents
In this age group the heart naturally beats faster than that of adults; therefore, in order to diagnose the syndrome, the rate must increase by at least 40 bpm when moving from sitting to standing.
Step 5. Undergo the "tilt test"
This is an alternative diagnostic procedure to measuring the heart rate in the two distinct positions; it consists of a very long and more detailed exam, in total it takes 30-40 minutes if you run the simple version, and up to 90 minutes if you proceed with the more complex one.
- The patient is made to lie down on a table that changes position respecting certain time intervals.
- During the exam, the body is connected to devices, such as an electrocardiographic machine and a blood pressure cuff, to constantly monitor vital signs, including heart rate and pressure.
- Doctors can evaluate the outcomes and use them to diagnose POTS or other heart-related disorders.
Step 6. Talk to your doctor about further investigations
There are many others that can help diagnose the disease. Your doctor can recommend catecholamine tests, blood pressure measurements after exposure to cold, electromyography, sweat tests, among many others. POTS is a heterogeneous disease, which means that it manifests itself in many different ways and has several underlying causes; consequently, the most suitable tests to make the diagnosis depend on the doctor's evaluations for your specific case.
Step 7. Be aware of the implications the disease can have on quality of life
For about 25% of people with POTS this parameter worsens up to the level of individuals considered officially disabled; this means not being able to work, having difficulty carrying out normal everyday activities, such as washing, eating, walking or even just standing. However, while for some patients the quality of life is reduced, others are still able to lead a normal existence and may not even be aware that they are ill if they are not informed.
- The prognosis is highly variable.
- When the syndrome arises suddenly following a viral infection (called a "post-viral episode"), about 50% of patients recover in two to five years.
- If you have been diagnosed with POTS, your doctor can give you the information specific to your case regarding prognosis and can work with you to develop a personalized treatment plan.
- The prognosis depends on the specific type of syndrome that affected you, the general health conditions, the underlying causes and the constellation of symptoms you exhibit (in addition to their severity).
- Among the non-drug treatments for the disease consider: eliminating factors that worsen it, reducing dehydration and increasing physical activity.
- Regarding drugs, there are no lasting studies on their effectiveness and all drugs are used "off-label".
