Symptoms
The hallmark symptom of POTS is an increase in heart rate from the supine to upright position of more than 30 beats per minute or to a heart rate greater than 120 beats per minute within 12 minutes of head-up tilt.
This tachycardic response is sometimes accompanied by a decrease in blood pressure and a wide variety of symptoms associated with hypotension. Low blood pressure of any kind may promote the following:
- lightheadedness, sometimes called pre-syncope (pre-fainting) dizziness (but not vertigo, which is also called dizziness)
- exercise intolerance
- extreme fatigue
- syncope (fainting)
- Excessive thirst (polydipsia)
Chronic or acute hypoperfusion of tissues and organs in the upper parts of the body are thought to cause the following symptoms:
- cold extremities
- chest pain and discomfort
- disorientation
- tinnitus
- dyspnea
- headache
- muscle weakness
- tremulousness
- visual disturbances
Autonomic dysfunction is thought to cause additional gastrointestinal symptoms:
- abdominal pain or discomfort
- bloating
- constipation
- diarrhea
- nausea
- vomiting
Cerebral hypoperfusion, when present, can cause cognitive and emotive difficulties. Symptoms that persist in the supine (recumbent) state are difficult to attribute to "cerebral hypoperfusion"
- brain fog
- burnout
- decreased mental stamina
- depression
- difficulty finding the right word
- impaired concentration
- sleep disorders
Inappropriate levels of epinephrine and norepinephrine lead to anxiety-like symptoms:
- chills
- feelings of fear
- flushing
- overheating
- nervousness
- over-stimulation
Symptoms of POTS overlap considerably with those of generalized anxiety disorder, and a misdiagnosis of an anxiety disorder is not uncommon.
Read more about this topic: Postural Orthostatic Tachycardia Syndrome
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