Dysautonomia
Postural Orthostatic Tachycardia Syndrome
POTS (= Postural Orthostatic Tachycardia Syndrome) is briefly described as a defect in the autonomic nervous system.
This means that all functions in the body that you have no control over are disrupted, with the main complaint being a significant increase in heart rate when sitting, standing and walking.
The term dysautonomia is an umbrella term for many autonomic dysfunctions, not only POTS but also OH (= orthostatic hypotension) and OI (= orthostatic intolerance).
POTS has several subdivisions and can come in a few different types:
Hypertension POTS, Hypovolemic POTS and Neuropathological POTS.
Although these subcategories are no longer used.
POTS is becoming increasingly common and is mainly caused by rare conditions.
Although POTS is not that rare, it is under-recognized or insufficiently known by doctors.
Dysautonomia (POTS) is currently still being fully researched, as well as the treatment methods.
There is also still much debate about the origin and cause of POTS as well as the treatment options for POTS, and it is increasingly suspected that POTS may be an autoimmune disease.
Some treatments are only indications that may help some patients that are not (yet) included in the literature and are only experiences during studies with POTS patients.
The road to the correct diagnosis...
Here you will find a list of symptoms that may be recognizable:
Tachycardia (high heart rate when sitting, standing and walking, but can also persist in a lying position and even at night), also palpitations and/or stabbing pains;
Bradycardia (slow heart rate) can also occur;
Low/high blood pressure fluctuations when standing/walking;
(Pre)syncope/feeling sick/fainting;
Fatigue;
Loss of cognitive ability (brain fog);
Dehydration due to low blood volume;
Problems with temperature regulation of the body (cold or heat intolerance);
Breathing problems that equate to complaints such as a panic attack (Air hunger);
Digestive problems;
Deconditioning (by lying down for long periods);
Adrenaline dump (sudden palpitations accompanied by sweating, nausea and chest discomfort).
The main complaint of POTS is that the heart beats at least 30 BPM faster than average and deviates from normal when standing/walking or in a lying position (abnormal rise).
Finding the right doctor is difficult because many people are not aware of POTS, many go from one consultation to another but are not helped.
Which doctor can help me if I suspect that I have POTS?
The doctors according to these specialties are most often mentioned:
Cardiologists
Internists
How can my doctor diagnose POTS?
The main test required is the tilt table test (TTT).
Meeting a few criteria such as an aggravation of complaints when standing/walking, blood pressure drops by 20/10 within three minutes while standing and the complaints improve when the patient lies down again.
A 24-hour measurement of heart rate and blood pressure.
Other possible conditions/causes must also be ruled out!
Typical complaints that may resemble POTS, such as dehydration, must also be excluded, although dehydration is also a POTS symptom.
Be sure to take the information brochure with you that you can find under literature on this website!
What treatments are available for POTS?
There is no concrete medicine yet to control or cure POTS, the condition is still under investigation and is not yet completely known, although POTS may probably be an autoimmune disorder.
Combating the complaints requires a multidisciplinary approach that can be different for each patient.
There are a few medications and aids available that can help POTS patients, helping to combat/reduce the symptoms and regain quality of life.
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Drinking electrolyte drinks/fluids up to 2.5-3 liters per day and 8 to 10-12 grams of salt
(for people suffering from hypertension, doctor's advice is recommended); -
Fludrocortisone: increases blood volume and regulates salt and fluid balance + blood pressure;
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Beta blocker: reduces heart rate;
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Compression clothing/support stockings: this is to prevent blood pooling in the lower part of the body. Choose class 2 compression stockings or clothing;
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Cardiovascular training: this can help you recondition if you have been down for a long time due to the condition in order to get your body functioning again under gravity;
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Therapeutic exercises that eliminate gravity can be a good start to rehabilitation, such as swimming;
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Aids can help such as a shower chair, mobility aids; portable stools and chairs, walking stick.
Self-discipline is very important with POTS, it requires a lot of effort and exercise training!
Some factors can worsen or flare up POTS, such as heat (taking a hot shower or bath), eating a heavy meal, becoming dehydrated, standing for long periods of time, consuming alcohol and carbohydrates, using caffeine/energy drinks.
Heartwatch
Measurements performed by an Apple Watch.
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POTS training schedule: CHOP Protocol
The correlation between dysautonomia and covid-19
Is there a connection of getting POTS after the Covid infection?
While many people recover quickly from COVID-19, the disease caused by the coronavirus, others who recover may continue to experience symptoms for months.
Researchers are still determining the cause of these long-lasting symptoms, but some COVID-19 "long-haulers" may be dealing with a known condition called postural orthostatic tachycardia syndrome.
This condition, also called POTS, affects involuntary functions of the nervous system, such as heart rate and blood pressure, usually when getting up from a lying position.
POTS can be caused by several conditions, including viral or bacterial infections.
Some researchers believe that the coronavirus may be a trigger for POTS, as an increasing number of people who have recovered from COVID-19 are now experiencing POTS-like symptoms, such as brain fog, tachycardia (increased heart rate), and severe chronic fatigue.
This similarity in symptoms led doctors to test patients for POTS.
The autonomic nervous system controls functions that we do not consciously control, such as heart rate, blood pressure, sweating and body temperature.
A malfunction in any of these areas can cause symptoms that can be shared by many conditions.
Doctors unfamiliar with POTS may dismiss these symptoms as lingering effects of COVID-19 – or even psychological symptoms.
At the same time, POTS can be very debilitating and require specific treatment, so an accurate diagnosis is vital.
Read the full article here
(source: Hopkinsmedicine.org