Postural orthostatic tachycardia syndrome
Abnormally high heart rate when standing / From Wikipedia, the free encyclopedia
Dear Wikiwand AI, let's keep it short by simply answering these key questions:
Can you list the top facts and stats about Postural orthostatic tachycardia syndrome?
Summarize this article for a 10 year old
Postural orthostatic tachycardia syndrome (POTS) is a condition characterized by an abnormally large increase in heart rate upon sitting up or standing.[1] POTS is a disorder of the autonomic nervous system that can lead the individual to experience a variety of symptoms.[10] Symptoms may include lightheadedness, brain fog, blurred vision, weakness, fatigue, headaches, heart palpitations, exercise intolerance, nausea, diminished concentration, tremulousness (shaking), syncope (fainting), coldness or pain in the extremities, chest pain and shortness of breath.[1][11][12] Other conditions associated with POTS include migraine headaches, Ehlers–Danlos syndrome, asthma, autoimmune disease, vasovagal syncope and mast cell activation syndrome.[10][13] POTS symptoms may be treated with lifestyle changes such as increasing fluid, electrolyte, and salt intake, wearing compression stockings, gentler and slow postural changes, avoiding prolonged bedrest, medication, and physical therapy.
Postural orthostatic tachycardia syndrome | |
---|---|
Other names | POTS |
Acrocyanosis in a male Norwegian POTS patient | |
Specialty | Cardiology, neurology |
Symptoms | More often with standing: lightheadedness, trouble thinking, tachycardia, weakness,[1] palpitations, heat intolerance, acrocyanosis |
Usual onset | Most common (modal) age of onset is 14 years[2] |
Types | Neuropathic POTS, Hyperadrenergic POTS, Secondary POTS. |
Causes | Antibodies against the Alpha 1 adrenergic receptor and muscarinic acetylcholine M4 receptor[3][4][5] |
Risk factors | Family history,[1] Ehlers Danlos Syndrome |
Diagnostic method | An increase in heart rate by 30 beats/min with standing[1] |
Differential diagnosis | Dehydration, heart problems, adrenal insufficiency, epilepsy, Parkinson's disease,[6] anemia |
Treatment | Avoiding factors that bring on symptoms, increasing dietary salt and water, compression stockings, exercise, medications[1] |
Medication | Off label Medications: Beta blockers, Ivabradine, midodrine, and fludrocortisone.[1] |
Prognosis | c. 90% improve with treatment,[7] 25% of patients unable to work[8] |
Frequency | ~ 1,000,000 ~ 3,000,000 (US)[9] |
The causes of POTS are varied.[14] POTS may develop after a viral infection, surgery, trauma, or pregnancy.[7] It has been shown to emerge in previously healthy patients after COVID-19,[15][16] or in rare cases after COVID-19 vaccination.[17] POTS is more common among people who got infected with SARS-CoV-2 than among those who got vaccinated against COVID-19.[18] Risk factors include a family history of the condition.[1] POTS in adults is characterized by a heart rate increase of 30 beats per minute within ten minutes of standing up, accompanied by other symptoms.[1] This increased heart rate should occur in the absence of orthostatic hypotension (>20 mm Hg drop in systolic blood pressure)[19] to be considered POTS. A spinal fluid leak (called spontaneous intracranial hypotension) may have the same signs and symptoms as POTS and should be excluded.[20] Prolonged bedrest may lead to multiple symptoms, including blood volume loss and postural tachycardia.[21] Other conditions which can cause similar symptoms, such as dehydration, orthostatic hypotension, heart problems, adrenal insufficiency, epilepsy, and Parkinson's disease, must not be present.[6]
Treatment may include avoiding factors that bring on symptoms, increasing dietary salt and water, small and frequent meals,[22] avoidance of immobilization,[22] wearing compression stockings, and taking medications.[23][24][1][25] Medications used may include beta blockers,[26] pyridostigmine,[27] midodrine[28] or fludrocortisone.[1] More than 50% of patients whose condition was triggered by a viral infection get better within five years.[7] About 80% of patients have symptomatic improvement with treatment, while 25 percent of patients are so disabled they are unable to work.[8][7] A retrospective study on patients with adolescent-onset has shown that five years after diagnosis, 19% of patients had a full resolution of symptoms.[29]
It is estimated that 1–3 million people in the United States have POTS.[30] The average age for POTS onset is 20 years, and it occurs about five times more frequently in females than in males.[1]