Rapid Heartbeat When You Stand? It Could be POTS

Do you feel lightheaded – enough that you might faint – after standing up? This could be a sign that you have postural orthostatic tachycardia syndrome, an unusual autonomic nervous system disorder also marked by an abrupt increase in heart rate.

Known as POTS, the condition can affect anyone, though it is more commonly found in women between the age of 15 and 50.

Unfortunately, researchers don’t know what causes the disorder, which affects up to 3 million people in the U.S. Some evidence suggests that the condition has been on the rise in the wake of the COVID-19 pandemic.

This serious condition can be alarming and life-altering, but it is not life-threatening.

Tough To Diagnosis

Lightheadedness and a rapid heartbeat are the most notable symptoms. But there are others, varying from person to person, that include:

• Fainting
• Difficulty focusing
• Nausea
• Unexplained exhaustion
• Anxiety or nervousness
• Bloating
• Headaches
• Clouded vision
• Shortness of breath
• Vomiting
• Abdominal discomfort

This wide range of potential symptoms creates issues with diagnosing the condition. Most of them are nonspecific and could be related to any number of disorders involving the heart. If POTS is suspected, a tilt-table test can help form a diagnosis.

The test involves being strapped to a table that starts in a horizontal position before being raised until you are in a near vertical position. Your doctor will monitor your heart rate, blood pressure and your heart’s electrical activity using ECG while asking a series of questions about how you are feeling and reacting to the positional changes.

POTS Causes and Impact

Whenever you stand up, it’s normal for some of your blood to flow out to your legs, arms and abdomen. With less blood reaching your brain, this could cause you to feel lightheaded. But this doesn’t generally happen, thanks to your leg muscles promptly pushing blood back up to your heart.

At the same time, your body also releases hormones that cause your heart rate to speed up a bit to keep your blood circulating.

For people with POTS, this mechanism doesn’t work the way it should. For unknown reasons, a larger amount of blood spreads out to your legs and other areas below the heart. When the leg muscles fail to push that blood back to the heart, it triggers a more significant release of those heart-stimulating hormones.

This dysfunction can be jarring, with your heart rate suddenly surging by 30 or more beats per minute within 10 minutes of standing. And even though it’s not a fatal condition, it can wreak havoc in your life.

In severe cases, it can cause you to faint after standing. Or you may feel like you are having a heart attack. Even exercising may be difficult, if not impossible, without treatment.

How Is POTS treated?

There is no cure for POTS, but it can be managed with treatment, focused on diet, lifestyle and medications. Symptoms of POTS can improve or resolve with time.

Diet: Among the most common recommendations are increasing both your water and salt consumption to boost your blood volume. Patients are urged to drink at least 96 ounces of water each day, while eating salty foods or taking salt tablets. Often, the increase in water and salt consumption alone can have a significant impact on symptoms.

It may also help to eat frequent smaller meals instead of fewer larger meals.

Lifestyle: Exercise and physical activity are important. Your doctor will work with you on an exercise plan, often focused on reclined aerobic exercises, including swimming and recumbent biking. Building stronger leg and core muscles can also help.

Other strategies include developing a slower transition from sitting to standing – taking several minutes to give your body a chance to adjust. Compression stockings may also be recommended to help your muscles contract to boost blood flow to the heart.

Medications: There aren’t any medications specifically approved for POTS. But there are several options that can be helpful in managing symptoms. These include medications that increase salt retention and others that help control your heartbeat.