POTS and Dysautonomia

Dysautonomia is the term used to describe a dysfunction of the autonomic nervous system. The autonomic nervous system regulates functions of your body that happen automatically, such as your heart rate, blood pressure, breathing, digestion, and temperature control. Since this system regulates a large portion of the body’s functions, a variety of symptoms can be felt when it’s not working properly. Symptoms include dizziness, fatigue, fainting, chronic pain, headaches, abnormal sweating, shakiness, breathlessness, nausea, vision issues and more. There are many types of dysautonomia, but the most common are postural orthostatic tachycardia syndrome (POTS), inappropriate sinus tachycardia, orthostatic hypotension and neurocardiogenic syncope.

Postural Orthostatic Tachycardic Syndrome (POTS) causes tachycardia (rapid heart rate) upon standing due to poor blood flow. Diagnosis involves a health history, physical exam, and tilt table test, where the patient’s heart rate, oxygen levels, and blood pressure are monitored as the table tilts. A heart rate increase of more than 30 beats per minute in adults or more than 40 beats per minute in children/adolescents confirms POTS.

 Orthostatic Hypotension is diagnosed when blood pressure drops upon standing: more than 20 mmHg for systolic or more than 10 mmHg for diastolic. Systolic = top number and Diastolic = bottom number with blood pressure.

Neurocardiogenic Syncope (vasovagal syncope) is fainting caused by a drop in heart rate and blood pressure. It can lead to complications like concussions and is diagnosed with a tilt table test.