These are common symptoms of PoTS and can last for a considerable time after a bout of symptoms of PoTS. Most people with PoTS also have migraine type headaches. Approximately two thirds of those with PoTS have orthostatic headaches which means they occur as a result of being upright and may be caused by reduced blood supply to the brain. Palpitations are a sensation of your heart pounding in your chest. Approximately 30 % of people with PoTS experience fainting. Dizziness or light-headedness or presyncope (almost fainting).These symptoms usually occur when standing up, but can occur with prolonged sitting.Symptoms can be debilitating, ranging from mild to severe and varying from day to day. In addition to heart rate and blood pressure, other bodily functions that are regulated by the autonomic nervous system can be affected. It means symptoms that occur on standing and are relieved by lying down. I hope this was helpful.Orthostatic intolerance is a term that is sometimes used to describe symptoms of PoTS. However, as mentioned previously, a repeat tilt table test is needed, non-pharmacological measures shall be tried first, and the medicines have to be taken only after being prescribed by your physician and under their guidance. Patients who neither have an increase in heart rate nor fall in BP but have orthostatic symptoms might benefit from medications like Methyldopa or Clonidine. An exercise program using rowing machines, recumbent cycles, or swimming are often better tolerated than upright exercises in patients with POTS. It can take four to six weeks for you to start to notice improvements. Regular exercise frequency (at least four days per week) with a session duration of at least 30 minutes must be followed.

Repeat the tilt-table test with a longer propranolol break.ġ) Increase water intake to three liters per day.Ģ) Increased salt intake up to 10 gm per day.Ĥ) Although uncomfortable, lower body compression garments such as waist-high-compression stockings or abdominal binders reduce venous pooling.ĥ) An exercise program featuring aerobic training can improve symptoms with some additional leg resistance training. I suggest following blood tests like CBC (complete blood count) and thyroid profile to rule out orthostatic intolerance due to secondary conditions. The treatment for both conditions remains the same as both are dysautonomia conditions of an autonomic nervous system disorder. The other can be PSWT (postural symptoms without tachycardia). Now there are many conditions that can be associated with orthostatic intolerance. I will mention them in the recommendations. A few blood tests to rule out any secondary condition will be required, if not already done. I do not have a baseline ECG (electrocardiography).īased on that, my opinion is that, although there are some competing diagnosis, the symptoms are most likely due to orthostatic intolerance, which means problems of BP (blood pressure) and HR on standing up. Her HR (heart rate) increase was a maximum of 13 BPM (beats per minute) higher than baseline. She underwent a tilt-table test for evaluation for POTS (postural orthostatic tachycardia syndrome) which was negative for that diagnosis. In the past, she has been on Fludrocortisone for the same. The patient has been on Propranolol LA for an unknown duration to which she has partially responded. There is no history of syncope (sudden onset transient loss of consciousness) mentioned. Attached is a picture that shows swelling in the leg ( attachments removed to protect the patient's identity) and mottling, which is suggestive of venous stasis. The patient suffers from multiple symptoms, likely autonomic, associated with prolonged standing, which improve on sitting or lying down and are worse in summer. As per your description, your current medical concerns are:ģ) Andrographis paniculata extract twice daily.

Pots symptoms checklist