Conditions Basics

What is postural orthostatic tachycardia syndrome (POTS)?

Postural orthostatic tachycardia syndrome (POTS) is a fast heart rate (tachycardia) that starts after you stand up. This can cause symptoms such as dizziness or weakness.

What causes it?

Experts don't understand what causes it, but different body systems seem to be out of balance. POTS may follow certain triggers such as a viral illness, a surgery, or pregnancy.

What are the symptoms?

Soon after you stand up, you may have symptoms such as:

• A fast, pounding heartbeat (palpitations).
• Trembling, dizziness, weakness, or light-headedness.
• Feeling faint or very tired.

With POTS, you may also have problems with:

• Blurred vision, headaches, nausea, and diarrhea.
• Trouble sleeping and feeling anxious.
• Keeping your attention focused.

Symptoms can range from mild to severe.

Some things can make symptoms worse. These include heat, menstrual cycle, dehydration, alcohol, exercise, and standing for a long time.

When you first notice symptoms, lying down may help you feel better.

How is it diagnosed?

To learn what is causing your symptoms, your doctor may:

• Ask about your symptoms, including when and how they started.
• Check how your blood pressure and heart rate change when you move from lying down to sitting to standing.
• Do blood tests.
• Check your heart with an electrocardiogram (EKG).

How is POTS treated?

Work with your doctor to find the right mix of treatments to help relieve symptoms and improve your quality of life. Treatment may include taking medicine prescribed by your doctor. For some people, taking medicine that affects blood pressure, like midodrine, can help. For others, medicines that help keep the heart rate low, like propranolol and ivabradine, can help. Taking medicine that keeps the body's fluids balanced, like fludrocortisone or desmopressin, may also help.