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Postural Tachycardia Syndrome (POTS)
Postural Tachycardia Syndrome (POTS):

POTS is an abnormal response by the autonomic (involuntary) nervous system to standing up. To be diagnosed with PoTS, a patient must experience the following:

A group of symptoms in an upright position (usually standing) that are relieved by lying down, these symptoms should be associated with an abnormally high and persistent increase in heart rate of 30 beats per minute (40 bpm if under 19 years of age) within ten minutes of standing.

Although symptoms are similar to those experienced by people with abnormally low blood pressure (BP), blood pressure does not usually drop in POTS. POTS can develop in a number of different diseases or situations. The reason for this is not properly understood but it is possible that there is a malfunction of the nervous system that controls autonomic functions in the body.


  • Dizziness or pre-syncope (almost fainting)
  • Syncope (fainting)
  • Palpitation (awareness of heartbeat)
  • Headaches - orthostatic headaches (due to upright posture)/migraine
  • Brain fog (difficulty in thinking)
  • Tiredness
  • Sense of anxiety
  • Shakiness Visual problems (greying, tunnel or glare)
  • Gut problems (nausea, diarrhoea, pain)
  • Sweating
  • Chest pain
  • Poor sleep
  • Purplish discolouration of skin due to blood pooling in hands and feet
  • Bladder problems

POTS symptoms can vary from day to day. They tend to multiply and become exaggerated upon upright posture. Blood flow and blood pressure regulation are also abnormal while supine or sitting, but these abnormalities may not be as apparent and may require orthostatic stress to become evident (Stewart & Erickson, 2002). Some patients do report symptoms occurring while sitting or lying down. Heat, exercise and eating can exacerbate symptoms. Women sometimes report an increase in symptoms around menstruation.
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