What is Postural Orthostatic Tachycardia Syndrome?

Postural orthostatic tachycardia syndrome (POTS) is one of many types of dysautonomia. Dysautonomia is “a disorder of autonomic nervous system (ANS) function that generally involves failure of the sympathetic or parasympathetic components of the ANS”. POTS specifically is “a blood circulation disorder characterized by a heart rate increase from horizontal to standing of at least 30 bpm and a specific group of symptoms that frequently occur when standing upright”. It’s also typically called fainting disease, but there’s so much more to it than that. 

I hadn’t heard of postural orthostatic tachycardia syndrome until I met my cardiologist in August 2021. I had known something was “different” with me since 7th grade tennis camp, but it took me 10 years to receive a diagnosis, which isn’t uncommon for people suffering with POTS. It’s tricky to conclude without having a test specifically meant to diagnose POTS, which means most general practitioners unfortunately don’t catch it. 

My diagnosis process took 5 months and all started because of my Apple Watch. I used to consistently workout and would easily hit a heart rate of over 200 bpm. I (stupidly) never looked into it until the day I got a notification during a workout to alert me that I was in Apple’s lowest level of cardio fitness. 

I thought back to the constant fainting I experienced - mainly each summer or whenever I got my period, my high heart rate, and the severe chest pains that hospitalized me with no explanation in high school - and then I scheduled an appointment with a cardiologist. 

Immediately, my cardiologist was certain that I had POTS, and was shocked that I hadn’t been diagnosed sooner. Through another appointment, wearing a Holter monitor, and a POTS exam, I was formally diagnosed in December 2021. The easiest symptom to see (and what can differentiate POTS symptoms from heart disease symptoms) is a rise in your heart rate by over 30 bpm when going from a sitting to standing position. 

Here are other common symptoms that you can look out for:

• Fainting

• Heat intolerance

• Dizziness

• Chest pain

• Brain fog

• Heart palpitations

• Intolerance of exercise

All POTS symptoms typically stem from the body’s inability to regulate heart rate. 

Even though I decided not to go on medication to manage my POTS, knowing the signs of attacks and being aware of actions that I can take to lessen my symptoms has helped so much.