{POTSSamm Sawyer

Postural Orthostatic Tachycardia Syndrome

Why POTS?

#POTSprobZ

When going from laying down or sitting position to standing causes an extreme increase in heart rate. (called tachycardia)

When a person’s body cannot effectively adjust to an upright postures’ pull of gravity, one is said to have orthostatic intolerance.

A person with POTS will experience heart rates that increase 30 beats or more per minute upon standing and/or increase to 120 beats or more per minute upon standing

Sometimes symptoms even occur while sitting or laying down.

Relates to the involuntary nervous system

What is POTS?

Found in adults, mostly women age 30-50.

Most commonly found in teenagers, right after one’s major growth spurt. Majority are actually found in high

achieving teens. Once again, mostly common in girls.

Who does this affect?

Not widely known, recognized about 15 years ago.

Often misdiagnosed as depression, anxiety or patient is told that it’s all in their head.

History

Lightheadedness Exercise

intolerance Extreme fatigue Excessive thirst Fainting Cold extremities Chest pain and

discomfort Disorientation Ringing in ears

Shortness of breath Headache Muscle weakness Visual disturbances Bloating Constant nausea Irritability Concentration

problems Mental clouding

Symptoms While pre-syncope is common in these patients, only a minority (~30%) actually pass out.

Got that Purple

Most teens are prescribed Beta Blockers, such as Fludricortosone, Amlodoipine, and Atenenol.

What these do is tighten the blood vessels so the aren’t limp so when one goes to stand, these tightened vessels are able to keep the blood pumping to the brain against gravity.

Almost everyone prescribed these beta blockers feels better after a year of being on beta blockers.

Sleep medication- to help with insomnia Stopping menstruation through birth control

What is done to help patients with POTS?

Exercise. This is one of the most difficult things for POTS patients cause their bodies constantly are telling them they are fatigued.

Eating more salt. Drinking a lot more fluid then one normally would.

Other things that help POTS

Makes everyday activities very difficult

Patients lack motivation Exercise is extremely

difficult Some patients find difficulty

going to work or school based on severity of symptoms.

How does POTS Affect one’s life?

Blood flow upon standing is restricted due to

How do you know?

Tilt table testing: often the standard method used for detecting POTS. A patient is strapped to a mechanical table, which will tilt them upright at an angle of at least 60 degrees. Measurements of heart rate and blood pressure are taken while lying flat and then again at intervals while tilted upright. The optimal duration of tilt testing in patients suspected of POTS is 40 minutes or until they faint, at which point the test is concludedcold pressure test The is used to activate the blood pressure control system. The patient places their hand in ice water during this test. The physician will monitor blood pressure changes.

Position the person on his or her back. Elevate feet Check the person's airway to be sure it's clear. Check for signs of circulation (breathing, coughing

or movement) If none, begin CPR and call 911 If so, wait for them to come to.

What to do if someone passes out on you?

What if you feel faint? • Lay on your back with your legs

bent at the knees, causing the blood from your legs rushes to your heart.

• Stay steated or lying till the spell passes

• Try to regulate breathing patterns • Drink water!

What causes POTS?

Adrenal Disorders (such as Assison’s disease)

Anemia Autoimmune Disorders Cardiac Diease Lesions Liver Diease Neuropathy Tumors Viruses

Mythbusters. True or False? POTS symptoms only occur while standing.FALSE: Many patients report symptoms occurring while sitting or lying down. Standing does exacerbate symptoms.

Everyone with POTS faints.FALSE: Many people with POTS have never fainted.

What do you do if you feel faint? A. Stand and continue to converse hoping the spell

will pass B. Stand next to someone you think will catch you C. Run in hopes of increasing heart rate D. Lay down with legs bent at knees

Alcohol- enhances venous pooling, which makes symtoms x10 worse and dehydrates

Anesthesia – only when absolutely nessesary, proven to be escpeaciallly difficult for POTS patients to handle

Bending up and down (as if picking something of the floor) increases symtoms due to change in blood flow

Blowing up balloons Certain foods (such as dairy products) Climbing stairs- exaggerates symptoms DEHYDRATION- the worst thing a patient can be in. Large meals Energy Drinks and coffee- speed up already speeding heart Extreme exercise Fatigue Giving Blood Heat Holding arms in air Lifting Singing (I personally beg to differ) STRESS Travel by airplane

What to avoid?