Is POTS a Serious Condition?
- Kayla Jane
- Jan 24, 2024
- 4 min read
Updated: Jul 5, 2024
Is POTS a serious condition? Answers to common questions
Postural Orthostatic Tachycardia Syndrome (POTS) can affect individuals of all ages, including children, adolescents, and adults. It is more commonly diagnosed in women, particularly in those of childbearing age. POTS is relatively new to the medical community, but statistics show that POTS has a prevalence of 0.2% to 1% in developed countries [6].
POTS is a form of dysautonomia, which involves dysfunction of the autonomic nervous system. The autonomic nervous system regulates involuntary functions such as heart rate, breathing, blood pressure, digestion, and body temperature.
The term "cookie-cutter version" refers to something that is standardized or lacking originality in a way that makes it look the same as many others. This expression comes from the concept of using a cookie cutter to make multiple cookies in the same shape and size, resulting in uniformity and a lack of uniqueness.
The POTS diagnosis or proposed treatment plans are rarely tailored to the individual patient's preferences or needs. In a health diagnosis scenario, a doctor often gives the same diagnosis and treatment plan to every patient with similar symptoms, without considering patients' individual differences, lifestyle, or underlying conditions. This approach might lead to suboptimal care.
In contrast, a tailored diagnosis of POTS involves personalized treatment plans, and consideration of the patient's unique situation, leading to potentially better outcomes.
Getting to the core of personalized treatment plans can be challenging. While the exact cause of POTS is not always clear, it often arises in individuals who have experienced an illness, surgery, trauma, or a period of prolonged bed rest. Developing POTS can be a serious condition in that it can severely affect the quality of life of a patient. Here we will discuss common factors that may be responsible or partially responsible for developing POTS.
Conditions Associated with Developing POTS
Some conditions and factors to take into consideration in that they may contribute to or be associated with POTS include:
1. Viral Infections: POTS symptoms may develop following a viral infection, such as mononucleosis or a respiratory infection. Recently, POTS has taken the spotlight more than ever because POTS can be a part of what is commonly referred to as Long-Haul Covid.
2. Joint Hypermobility Syndromes: There is a higher prevalence of POTS among individuals with conditions like Ehlers-Danlos syndrome and other joint hypermobility syndromes. There are several types of EDS, and it is fairly common affecting approximately 1 in 5,000 [5].
3. Small Fiber Neuropathy: Individuals with small fiber neuropathy, a condition affecting the small nerves in the skin and other organs, may experience POTS symptoms. Approximately 50 percent of POTS patients experience small fiber neuropathy that significantly impacts the nerves. Small fiber neuropathy is usually diagnosed through skin biopsy by a neurologist [2].
4. Autoimmune Disorders: Some autoimmune conditions, such as Sjogren's syndrome and lupus, have been associated with POTS. To test for autoimmune disorders, a good starting point is to test for Antinuclear Antibodies (ANA). ANA testing is recommended when an alternative diagnosis is suspected. A combination of positive ANA and a skin biopsy to confirm Small Fiber neuropathy diagnosis, point in the direction of the patient having Sjogren's. Sjogren's is confirmed by having a lip biopsy--LSGB (labial salivary gland biopsy). Although Sjogren's is an autoimmune condition often times known to accompany POTS, only 11% of POTS patients have Sjogren's [4].
5. Chiari Malformation: POTS may coexist with Chiari malformation, a structural defect in the base of the skull. Both are known to be common with Chronic Fatigue Syndrome and Fibromyalgia, but there is not much medical literature available with a scientific explanation of the correlation [3].
6. Deconditioning: Prolonged bed rest or inactivity can lead to deconditioning of the cardiovascular system, potentially triggering POTS. After long-term bed rest due to surgery, some people seem to be healed only to find out that they have new struggles with everyday activities due to POTS.
7. Trauma: POTS can develop after traumatic events, surgeries, or procedures. Significant blood loss could serve as a factor in the development of POTS. The probability of the development of POTS is increased after exposure to trauma but is not limited to physical trauma. Emotional trauma can serve as a factor in POTS diagnosis. Childhood trauma can result in the development of POTS later in adult life. Significant stressors, in general, play a large role in developing POTS.
8. Genetic Factors: While not fully understood, there may be a genetic component, as POTS sometimes occurs in multiple family members. A genetic background in POTS is found to be in those who developed POTS symptoms in childhood or adolescence through the gene polymorphisms GNB3 C825T. Studies show that this gene "might be a risk factor for POTS through the enhanced vagal withdrawal of the heart" [1].
It's essential to note that the specific triggers or underlying causes can vary among POTS individuals. The hallmark symptom of POTS is an increase in heart rate of at least 30 beats per minute (or a heart rate exceeding 120 beats per minute) within 10 minutes of standing up. Other common symptoms include dizziness, lightheadedness, and fainting.
Treatment Options to Consider
Individuals experiencing symptoms suggestive of POTS should seek medical evaluation and diagnosis by healthcare professionals who specialize in autonomic disorders or cardiology. Treatment approaches may include lifestyle modifications, medications, and stress reduction to improve symptoms and quality of life.
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