Postural Orthostatic Tachycardia Syndrome
& Dysautonomia

What is Postural Orthostatic Tachycardia Syndrome?

Postural Orthostatic Tachycardia Syndrome (POTS) is an inappropriate bodily response to upright position. Normally, when we go from lying to standing, the body needs to pump the blood against gravity to maintain proper blood flow to the upper body, especially the brain. When this does not happen, one may feel heart racing (palpitations), lightheadedness, fatigue, brain fog, or shortness of breath. The medical definition of POTS in adults is a heart rate that increased by 30 beats per minute within 10 minutes of standing. Some patients may be referred to a cardiologist for tilt table testing to diagnose POTS, but an active stand test may be sufficient (1). POTS represents a dysfunction of the autonomic nervous system. It can be triggered by viral infections (esp COVID), autoimmune disease, connective tissue disorders (such as hypermobility and EDS), head trauma or other neurologial diseases.

What is Orthostatic Hypotension?

Orthostatic hypotension (OH) is distinct from POTS. In POTS, the heart rate increases upon standing, but the blood pressure does not significantly drop. In OH, there is a sustained drop in systolic blood pressure (top number) of > 20 mmHg or diastolic blood pressure (bottom number) of > 10 mmHg within the first 3 minutes of standing. OH often results in similar symptoms as POTS.

What is Dysautonomia?

Dysautonomia is an umbrella term for all disorders related to malfunction of the autonomic nervous system. POTS and OH are both forms of dysautonomia. The autonomic nervous system controls bodily functions that happen automatically, without our thinking about it, including heart rate, blood pressure, temperature, and digestion. Therefore, dysautonomia can also manifest as heat or cold intolerance, excessive sweating, inability to regulate body temperature, nausea, bloating, constipation, diarrhea, fatigue, brain fog, or exercise intolerance.

How do I know if I have POTS, OH or other Dysautonomia?

If you are suffering with heart racing, lightheadedness, cold/ heat intolerance, gastrointestinal concerns, fatigue, brain fog, or shortness of breath and suspect you may have some form of dysautonomia, you may click below to schedule an appointment with Dr. Jennifer Tang for evaluation and treatment in California.