It's also known as postural orthostatic tachycardia syndrome (POTS). Although there's currently no cure, it can be managed with changes to your lifestyle or with medicines.
Postural tachycardia syndrome (PoTS) affects everyone differently. Some people have mild symptoms, while for others it can have a big impact on their everyday lives.
Some symptoms happen when you stand up and can get better when you sit or lie down, such as:
- dizziness or light-headedness
- noticeable heartbeats (heart palpitations)
- chest pain
- shortness of breath
- shaking and sweating
- fainting or nearly fainting
You may also get other symptoms, such as:
- problems with your stomach or digestion, such as feeling sick, being sick, diarrhoea, constipation, bloating and tummy pain
- headaches and problems with your sight, such as blurred vision or tunnel vision
- your hands and feet looking purple – this may be more difficult to see if you have brown or black skin
- weakness and extreme tiredness (fatigue), not being able to do much exercise, and sleeping badly
- problems with thinking, memory and concentration (brain fog)
You may find your symptoms are worse in the morning, and they may change from day to day.
Symptoms of PoTS can be similar to those of other conditions, such as low blood pressure. Having these symptoms does not mean you definitely have PoTS.
It's not clear what causes postural tachycardia syndrome (PoTS). It can develop suddenly or gradually over time.
You may be more likely to have PoTS if you have a condition such as long COVID, myalgic encephalomyelitis (ME) or chronic fatigue syndrome (CFS), or joint hypermobility syndrome.
Some things can also make your symptoms worse, such as:
- getting too hot
- standing or sitting upright for long periods of time
- eating, especially carbohydrates like white bread, pasta and rice
- not drinking enough fluids
- drinking alcohol
- resting too much
- exercise
- being on your period
If you have symptoms of postural tachycardia syndrome (PoTS), it's important to get them checked out.
See a GP if:
- you have symptoms of postural tachycardia syndrome (PoTS)
If you have symptoms of postural tachycardia syndrome (PoTS), a GP may check your blood pressure and heart rate before and after you stand up.
If the doctor asks you to repeat the process several times, this is called an active stand test.
You may also have some blood tests, to check for other conditions that might be causing your symptoms, and an electrocardiogram (ECG).
You may be referred to a specialist if:
- making changes to your lifestyle does not help
- you're very unwell
- it's not clear what's causing your symptoms
The specialist may perform more tests, such as:
- blood tests
- pee (urine) tests
- heart and blood pressure tests, such as an echocardiogram, ECG, and 24-hour blood pressure and heart rate monitoring
- a tilt table test, where you lie on a flat bed that's tilted upwards so your heart rate can be monitored
It can take time for people to be diagnosed with PoTS as the symptoms are similar to other conditions.
Find out more about tests to diagnose PoTS on the PoTS UK website
If you're diagnosed with postural tachycardia syndrome (PoTS), finding the right treatment for you can take time.
A GP or specialist may suggest lifestyle changes first, such as drinking more fluids, eating small meals with fewer carbohydrates, and wearing support tights or stockings (compression clothing).
You may be prescribed medicines to help control your symptoms, such as fludrocortisone (a steroid), and medicines used to treat heart conditions and manage your blood pressure, such as beta blockers.
You may also need to try several different medicines or combinations of medicines.
If you have postural tachycardia syndrome (PoTS), there are things you can try to help ease your symptoms.
If you suddenly feel faint or dizzy, you can try lying down and raising your legs until you feel better.
If you cannot lie down, you can try:
- crossing your legs with 1 in front of the other while standing
- rocking up and down on your toes
- clenching your buttocks and tummy muscles
- clenching your fists
Making changes to your lifestyle may also help with PoTS.
Do
try to avoid the things that trigger your symptoms
drink plenty of fluids until your pee is pale
try gentle exercise, such as walking, pilates and swimming – be careful when exercising and stop if you have any symptoms
raise the head of your bed so you're not lying completely flat
wear support tights to improve blood flow
Don't
do not stand up for too long
do not get up too quickly after lying down – sit for a while before standing up
do not drink too much caffeine or alcohol
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