Postural orthostatic tachycardia syndrome history and symptoms

The hallmark symptom of POTS is an increase in heart rate from the supine to upright position of more than 30 beats per minute or to a heart rate greater than 120 beats per minute within 10 minutes of head-up tilt. This tachycardic response is often accompanied by a profound decrease in blood pressure and a wide variety of symptoms associated with hypotension including:

• Lightheadedness, sometimes called pre-syncope (pre-fainting) dizziness (but not vertigo which involves a spinning sensation, or dizziness)
• Exercise intolerance
• Extreme fatigue
• syncope (fainting)

Chronic or acute hypoperfusion of tissues and organs in the upper parts of the body are thought to cause the following symptoms:

• Cold extremities
• Chest pain and discomfort
• Disorientation
• Dyspnea
• Headache
• Muscle weakness
• Tremulousness
• Visual disturbances

Autonomic dysfunction is thought to cause additional gastrointestinal symptoms:

• Abdominal pain or discomfort
• Bloating
• Constipation
• Diarrhea
• Nausea
• Vomiting

Cerebral hypoperfusion can cause cognitive and emotive difficulties:

• Brain fog
• burnout
• Decreased mental stamina
• Depression
• Word finding difficulty
• Impaired concentration
• Sleep disorders

Inappropriate levels of epinephrine and norepinephrine lead to anxiety-like symptoms:

• Chills
• Feelings of fear
• Flushing
• Overheating
• Nervousness
• Over-stimulation

Symptoms of POTS overlap considerably with those of generalized anxiety disorder, and a misdiagnosis of an anxiety disorder is not uncommon.

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