Postural Orthostatic Tachycardia Syndrome (POTS)

Postural orthostatic tachycardia syndrome (POTS) is a relatively uncommon condition affecting the body's blood pressure and heart rate control system (the autonomic nervous system).

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What are the symptoms of postural orthostatic tachycardia syndrome?

Postural orthostatic tachycardia syndrome (POTS) causes your heart rate to increase faster than normal after getting up from sitting or lying down. It can also lead blood pressure to fall. POTS has a range of possible symptoms that vary from person to person, including:

Fatigue
Dizziness or feeling light-headed
Fainting (syncope)
Palpitations
Breathlessness
Chest pain (angina)

People with POTS can also suffer with other symptoms related to dysfunction of the autonomic nervous system:

Irritable bowel syndrome
Headaches and migraines
Disturbed sleep patterns
Forgetfulness or trouble focusing
Shaking or excessive sweating
Feeling anxious or nervous

When to see a doctor

If you are experiencing any of the above symptoms, it does not necessarily mean that you have POTS. Many of the symptoms associated with POTS can also be linked to other medical or heart conditions.

If you are concerned about POTS or any of the symptoms mentioned above, contact your doctor as soon as possible. Alternatively, you can book an appointment with one of our heart rhythm specialists. We also offer a private GP service with same-day appointments available.

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A wealth of treatment options: We offer a wide range of treatments for POTS, and our expert consultants will always offer you the most effective option for your condition.
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Swift access to tests: You'll get an appointment confirmed within 24 hours of contacting us, and any results from diagnostic tests will be provided within 48 hours.

What is postural orthostatic tachycardia syndrome?

Postural orthostatic tachycardia syndrome (POTS) is a blood circulation disorder that causes your heart rate to increase very quickly when you move from sitting or lying down to standing up, and blood pressure to fall.

Postural: The position of the body

Orthostatic: Related to standing upright

Tachycardia: A heart rate over 100 beats per minute

Syndrome: A group of symptoms that occur together

POTS impacts the autonomic nervous system which regulates functions in the body that people don't consciously control, such as blood pressure, heart rate and body temperature. The autonomic nervous system, when functioning properly, keeps blood flowing around your body at a healthy pace, regardless of the position your body is in.

When we sit or lie down, blood pools in the lower half of the body and causes a natural drop in blood pressure. If you have POTS, your nervous system does not automatically respond when you stand up. To compensate, your heart rate increases in an attempt to pump blood to the upper half of the body. This can cause symptoms such as dizziness and feeling faint or palpitations.

Some people only experience mild symptoms from POTS, while others can find the condition seriously impacts their quality of life and the ability to complete everyday tasks.

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Who does POTS commonly affect?

POTS most commonly affects women aged between 15 and 50, although men also experience this condition. People may be at a higher risk of developing POTS if they have or are experiencing the following:

Physical trauma, such as a head injury
Surgery
Significant illnesses or serious infections, including previous COVID-19 infection
People with autoimmune conditions, such as lupus or Sjögren’s syndrome
Pregnancy

Medical conditions similar to POTS

Many conditions share similar symptoms to POTS.

Inappropriate sinus tachycardia (IST) is a related condition that’s also due to autonomic nervous system dysfunction. In IST, the resting heart rate consistently sits above 100 beats per minute and increases further with exercise. This causes persistent palpitations. IST can often be treated through medication.

Vasovagal syncope, or frequent fainting, is also related to POTS and due to malfunction of the autonomic nervous system. The predominant symptom in vasovagal syncope is loss of consciousness or profound dizzy spells. Faints commonly occur in certain circumstances such as:

Hot and crowded environments
Standing or sitting for too long
Stressful situations
After eating a large meal
After consuming too much alcohol
When going to the toilet, particularly at night time

What can cause symptoms of POTS to worsen?

People may find that their POTS symptoms get worse in different situations:

Being stood up for a long time
Not eating enough or drinking enough fluids
Increased body temperature, such as after a hot bath or shower, or spending time outside on a hot day
Participating in strenuous exercise
Feeling unwell from a cold or an infection

How is POTS diagnosed?

If your GP suspects you may be experiencing symptoms of POTS, you'll be referred to a cardiologist for further investigation.

It may not be straightforward for healthcare providers to easily diagnose POTS, as many symptoms can potentially be explained by other causes, and they can impact each individual differently.

There are a range of available tests to diagnose POTS and to help rule out any other potential conditions, which include:

Tilt-table test: If you are experiencing dizzy spells or feeling faint, this test can be used to check if they're related to a slow heart rate. During the test, you'll lie on a bed which slowly tilts and a consultant will monitor your heart rate and any symptoms that may arise.
Echocardiogram: A detailed look at the structure of the heart, which can identify any areas of damage.
Electrocardiogram (ECG): This test measures electrical activity in the heart and can be done in a doctor's office.
Ambulatory echocardiogram: A device worn on the chest which measures your heart rate as you go about your daily activities.
Cardiopulmonary exercise test: A CPET checks how well your heart and lungs work during exercise by monitoring breathing, heart rate and blood pressure.
Blood tests: To check how much oxygen and carbon dioxide are in your blood.

Postural orthostatic tachycardia syndrome treatment options

Unfortunately, there isn't a cure for POTS, but our consultants may recommend a range of treatments to help manage the symptoms.

Treatment options for POTS will vary on an individual basis, as the severity of your symptoms and any underlying conditions will determine what course of action best suits your needs.

Lifestyle changes

Making some small lifestyle changes can dramatically improve your POTS.

Drink more water: Drinking between 2-3 litres of water each day will improve your blood volume and help oxygen reach the heart faster.
Add more salt to your diet: Studies have shown that increasing your sodium intake can also help to increase blood volume which is often low in people with POTS. Drinking Lucozade or adding electrolyte powders to food or drinks is often healthier than eating table salt.
Cut down on alcohol and caffeine: Certain foods and drinks can aggravate symptoms of POTS in some people.

Our POTS specialists can help you find the most effective way to alter your diet that is best suited to your condition.

Physical exercise

Maintaining an active lifestyle and regular physical activity is one of the most effective ways to manage POTS. However, it should be noted that suddenly changing your physical activity routine could cause your symptoms to worsen, so this should be done gradually over time.

We can help you come up with an exercise plan that is tailored to your needs and your condition.

Some of the most effective types of physical activity for alleviating symptoms of POTS are gentle exercises such as walking, swimming, water aerobics or yoga, which can help to circulate the blood in your body without needing strenuous exercise. These forms of exercise will also help to strengthen your core and leg muscles, which in turn will help boost your blood flow.

Medication

As symptoms of POTS can vary from person to person, there is no single medication that is effective for treatment in all people. Our specialist cardiologists will assess your condition and work out the most effective medication to take to control your symptoms.

Some of the most commonly prescribed medications for the treatment of POTS are:

Fludrocortisone: This medication is commonly prescribed to help return the heart rate to a normal pace and reduce the frequency of abnormal heart rhythms by helping the kidneys retain sodium.
Midodrine: This is used to increase and maintain blood pressure by causing the blood vessels to narrow.
Beta blockers: By slowing the heart rate down and reducing blood pressure, beta blockers can help reduce upright tachycardia.

Finding the most effective POTS treatment for you

If you require treatment for POTS, our specialist consultants will be able to recommend the most effective treatment options for you.

We treat X arrhythmia patients per year, more than any other private healthcare provider. Our wealth of experience treating conditions like POTS means we provide excellent outcomes for individuals in our care.

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Get an appointment with a cardiologist for POTS

Our extensive network of cardiologists specialises in diagnosing, treating and helping you manage the symptoms of your POTS.

Use our consultant finder tool to view their profiles, experience and expertise, before booking an appointment directly. Alternatively, you can request an appointment and we will connect you with the right expert to treat your condition.

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Paying for your private POTS treatment

There are a few different payment options available when it comes to your care. Your postural orthostatic tachycardia syndrome treatment may be covered by private medical insurance.

We would advise contacting your insurer to discuss your condition and to select HCA UK as your preferred provider. Self-payment options are also available.

Find out more about how to pay for your treatment