POTS

What is POTS?

Postural orthostatic tachycardia syndrome (POTS) is a form of dysautonomia that has a primary symptom of orthostatic intolerance (OI). POTS is characterized by a rapid increase in heart rate of more than 30 bpm (40 bpm in children) or a heart rate that exceeds 120 bpm within 10 minutes of standing. POTS symptoms include but are not limited to lightheadedness, fainting, tachycardia, chest pain, shortness of breath, GI distress, shaking, exercise intolerance, and/or temperature sensitivity. POTS is most common in women ages 15-50 and often begins following an event such as pregnancy, major surgery, trauma, or a viral illness such as COVID-19.

What is Dysautonomia?

Dysautonomia is an umbrella term for disorders that cause malfunctioning of the autonomic nervous system (ANS). The ANS controls automatic functions in the body such as heart rate, blood pressure, temperature, digestion, and constriction and dilation of the pupils of your eyes. Patients who have dysautonomia have dysregulation of their ANS, which can lead to difficulties regulating these systems. Dysautonomia can lead to lightheadedness, fainting, unstable blood pressure, abnormal heart rates, and malnutrition.  

How can Physical Therapy help with POTS treatment and management?

Although there is no cure for POTS at this time, there are several ways to treat and medically manage symptoms of POTS including physical therapy. Exercise intolerance is often a symptom of POTS patients due to POTS symptoms being exacerbated by upright positioning. Because of this, POTS patients often struggle with physical deconditioning, decreased cardiac output, stroke volume, and low tone, which can lead to worsening of POTS symptoms. Horizontal or recumbent exercise programs allow patients to return to exercise, improving stroke volume, muscle tone, and expanding blood volume. Research shows that exercise in a controlled environment can be a very effective treatment for POTS, allowing patients to return to daily life and activity. Strength training for the core musculature and lower extremities increases venous return to the heart due to a leg pumping motion. This helps avoid blood pooling. Increasing muscle tone improves the body's ability to tolerate positional changes such as standing upright for long periods of time.  

How can I find out more about POTS?

Dysautonomia International: https://dysautonomiainternational.org/

Informational video: https://vimeo.com/292473119?embedded=true&source=vimeo_logo&owner=19630283

How to find a POTS doctor near me?

Dysautonomia International: https://dysautonomiainternational.org/page.php?ID=14

References: 

https://www.ninds.nih.gov/health-information/disorders/postural-tachycardia-syndrome-pots#:~:text=Postural%20orthostatic%20tachycardia%20syndrome%20(POTS,from%20a%20lying%20down%20position.
https://dysautonomiainternational.org/page.php?ID=34
https://vimeo.com/292473119?embedded=true&source=vimeo_logo&owner=19630283
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6289756/
https://www.dysautonomiainternational.org/pdf/CHOP_Modified_Dallas_POTS_Exercise_Program.pdf