Postural tachycardia syndrome (PoTS) is an abnormal increase in heart rate that occurs after sitting up or standing. Some typical symptoms include dizziness and fainting.
It's sometimes known as postural orthostatic tachycardia syndrome.
PoTS affects a range of people but is most common in girls and women aged 15 to 50.
Some people have mild symptoms, while others find the condition affects their quality of life. PoTS often improves gradually over time, and there are some medicines and self-care measures that can help.
Normally when you sit up or stand, gravity pulls some of your blood down to your belly area, hands and feet.
In response, your blood vessels quickly narrow and your heart rate increases slightly to maintain blood flow to the heart and brain, and prevent blood pressure dropping.
This is all done without needing to think about it, by the autonomic nervous system – the nervous system in charge of automatic body functions.
In PoTS, the autonomic nervous system does not work properly. There's a drop in blood supply to the heart and brain when you become upright and the heart races to compensate for this.
You can develop PoTS suddenly, or it can begin gradually.
You can sometimes get symptoms almost immediately, or a few minutes after sitting up or standing. Lying down may relieve some of the symptoms.
Typical symptoms of PoTS include:
Some people notice that feeling hot, eating, strenuous exercise or having a period can make their symptoms worse.
See a GP if you think you have PoTS.
Some doctors may not be aware of PoTS, so it may help to print out this page and take it with you to your appointment. A GP will probably need to refer you to a specialist for tests (see below).
PoTS UK (a charity for people affected by PoTS) has a list of doctors with an interest in PoTS that you can use to find a specialist near you. You cannot usually self-refer to these doctors, but you could discuss a referral with a GP.
PoTS is diagnosed if your heart rate increases by 30 beats a minute (bpm) or more (40bpm in those aged 12 to 19) usually within 10 minutes of standing. This increase continues for more than 30 seconds and is accompanied by other symptoms of PoTS.
You may have a range of tests to confirm a diagnosis and rule out other conditions, including:
Self-care measures can sometimes help to reduce the symptoms of PoTS. If these do not work, you may need to take medicine.
If you suddenly feel faint or dizzy, you can try countering the fall in blood flow by:
You may be able to reduce your symptoms in the long-term if you:
There's currently no medicine licensed for the treatment of PoTS, but your specialist might suggest trying a medicine "off label", such as:
If a medicine is used "off label", it means it has not undergone clinical trials for this use, but many experts believe it's likely to be effective and your doctor will discuss the possible benefits and risks with you.
Sometimes the cause of the problem with the nervous system in people with PoTS is unknown.
Teenagers will sometimes develop PoTS and find it gradually disappears a few years later. Sometimes it can develop suddenly after a viral illness or traumatic event, or during or after pregnancy.
Some of the other known causes are:
PoTS also happens quite commonly alongside chronic fatigue syndrome.
The following organisations can provide more information, support and advice for people with PoTS: