If you are experiencing dizziness or lightheadedness when standing up, you may be suffering from postural orthostatic tachycardia syndrome (POTS). POTS is a condition that affects the autonomic nervous system, causing an abnormally high heart rate and other symptoms. In this article, we will explain how to test for POTS and provide you with some simple tips for a quick diagnosis.
What is POTS?
POTS is a condition that affects the autonomic nervous system, which controls involuntary functions like heart rate, blood pressure, sweating, and digestion. POTS is a type of dysautonomia, which refers to any disorder of the autonomic nervous system.
People with POTS experience a rapid increase in heart rate when they stand up, often accompanied by dizziness, lightheadedness, and fainting. Other symptoms of POTS can include fatigue, brain fog, chest pain, shortness of breath, and digestive issues.
How is POTS Diagnosed?
Diagnosing POTS can be challenging because there is no single test that can confirm the condition. However, there are several diagnostic tests that your doctor can perform to help determine if you have POTS.
1. Tilt Table Test
The tilt table test is the most common diagnostic test used to diagnose POTS. During this test, you will lie flat on a table and be tilted upright at a 70-degree angle. Your blood pressure and heart rate will be monitored while you are in the standing position.
If your heart rate increases by 30 beats per minute or more within 10 minutes of standing, and if you experience symptoms like dizziness and lightheadedness, you may have POTS.
2. Blood Tests
Your doctor may order blood tests to check your blood levels of certain hormones and electrolytes that can affect your autonomic nervous system. These tests can help rule out other conditions that may mimic the symptoms of POTS.
3. Autonomic Function Tests
Autonomic function tests (AFTs) measure the activity of your autonomic nervous system. Your doctor may perform AFTs to evaluate the function of your cardiovascular, gastrointestinal, and sudomotor (sweating) systems, which can all be affected by POTS.
How to Prepare for POTS Tests?
Before your POTS diagnostic tests, your doctor may ask you to stop taking medications that can affect your heart rate and blood pressure. These medications may include beta-blockers, caffeine, and certain antidepressants.
You should also avoid consuming large amounts of liquids and salty foods in the hours leading up to your test, as these can affect your blood pressure and make it more difficult to detect the changes in heart rate that are associated with POTS.
What are the Treatments for POTS?
While there is no cure for POTS, there are several treatments that can help manage the symptoms of the condition.
1. Lifestyle Changes
Simple lifestyle changes can make a big difference for people with POTS. Some effective strategies include:
- Drinking plenty of fluids to help maintain blood volume
- Increasing salt intake to help raise blood pressure
- Wearing compression stockings to improve blood flow in the legs
- Eating small, frequent meals to prevent a drop in blood sugar
- Avoiding standing or sitting for long periods of time
- Engaging in regular aerobic exercise to improve cardiovascular fitness
Several medications can be used to treat the symptoms of POTS, including:
- Beta-blockers to lower heart rate and improve blood pressure
- Fludrocortisone, a steroid that helps the body retain salt and water
- Midodrine, a medication that raises blood pressure by constricting blood vessels
- Ivabradine, a medication that slows the heart rate
3. Other Treatments
In some cases, your doctor may recommend other treatments for POTS, such as:
- Intravenous saline (saltwater) to increase blood volume
- Physical therapy to improve muscle strength and flexibility
- Cognitive-behavioral therapy to help cope with the emotional impact of POTS
POTS is a condition that can cause significant discomfort and impair quality of life. If you are experiencing symptoms of POTS, it’s essential to see a doctor for a proper diagnosis. The diagnostic tests for POTS are safe and straightforward, and there are many effective treatments available. With proper care and management, people with POTS can lead healthy, fulfilling lives.
Here are some of the most common questions and their answers related to testing for POTS:
- Q: Do I need to fast before POTS testing?
- A: You do not need to fast before POTS testing, but you should avoid consuming large amounts of liquids and salty foods in the hours leading up to your test.
- Q: How is POTS diagnosed?
- A: POTS is diagnosed through a combination of symptoms, medical history, and diagnostic tests, including the tilt table test, blood tests, and autonomic function tests.
- Q: Can POTS be cured?
- A: There is no cure for POTS, but there are several treatments that can help manage the symptoms of the condition.
- Q: What are the symptoms of POTS?
- A: The symptoms of POTS include a rapid increase in heart rate, dizziness, lightheadedness, fainting, fatigue, brain fog, chest pain, shortness of breath, and digestive issues.
- Ahmed A (2019). “Postural Orthostatic Tachycardia Syndrome.” In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing.
- Garland EM, Raj SR, Black BK, et al. The hemodynamics and mechanisms of thododrine in the treatment of postural orthostatic tachycardia syndrome. Circulation. 2010;122:1749-1757. doi:10.1161/CIRCULATIONAHA.110.940625
- Sheldon RS, Grubb BP 2nd, Olshansky B, et al. 2015 Heart Rhythm Society Expert Consensus Statement on the Diagnosis and Treatment of Postural Tachycardia Syndrome, Inappropriate Sinus Tachycardia, and Vasovagal Syncope. Heart Rhythm. 2015;12(6):e41–e63. doi:10.1016/j.hrthm.2015.03.029