Chronic Orthostatic Intolerance
Postural tachycardia syndrome (POTS) is a disorder characterized by a pulse rate that is too fast when the patient stands. Symptoms include rapid heartbeat, lightheadedness with prolonged standing, headache, chronic fatigue, chest pain, and other nonspecific complaints. Causes of POTS usually are not identified in individual patients. Reversible causes such as low blood volume should be ruled out.
Treatment of POTS depends upon the severity of the symptoms. Individuals with the disorder are usually advised to increase their fluid and salt intake. Body stockings may provide some relief. Drug therapy, with fludrocortisone, beta-blockers, midodrine, or clonidine, can be beneficial. Physical exercise, especially calf muscle resistance training, also may help. Some patients may require and benefit from insertion of a cardiac pacemaker.
The prognosis for individuals with POTS varies. Many patients improve with treatment, although severe POTS can be disabling for years. The disorder is not thought to progress to a cardiac disease.
Prepared by the National Institutes of Health