Postural orthostatic tachycardia syndrome (POTS) is a condition that causes an effect called orthostatic intolerance. This means that when you stand up, you may experience symptoms that include:
- rapid increase in your heart rate
- feeling faint
These effects can significantly impact your quality of life.
Because POTS causes changes in your heart rate, it’s easy to wonder if POTS can have other effects on your heart, such as heart failure. While the two conditions may have similar symptoms, doctors haven’t made a connection that POTS causes heart failure.
Keep reading to learn more about how POTS affects your heart and when you should contact a doctor or healthcare professional.
- Heart attack is when part of your heart doesn’t get enough oxygen. As a result, your heart tissue can die and fail to pump blood, which can be deadly.
- Heart disease describes different conditions that affect your heart’s functioning and includes coronary artery disease. A heart attack can be a symptom of heart disease.
- Heart failure is when your heart doesn’t pump enough blood to meet your body’s demands. Heart disease is a risk factor for heart failure.
POTS causes your heart rate to increase by
An increased heart rate can cause palpitations as if your heart is fluttering. You may even feel like you’re going to faint because your heart is beating so fast that it can’t get blood to other parts of your body or because your blood pressure goes down.
Other heart-related symptoms you may experience due to POTS include:
- a bluish tint to your extremities due to poor oxygen
- chest pain
- dyspnea, or exercise intolerance
If these symptoms sound familiar, it’s because they can mimic some conditions related to heart disease. For example, a heart attack can cause chest pain, shortness of breath, and fainting. Heart failure can cause arm and leg swelling, shortness of breath, and a bluish tint to your extremities.
While these symptoms can occur during an episode of orthostatic intolerance related to POTS, they don’t usually last long. Lying down can help your symptoms resolve. If you were experiencing a heart attack or had heart failure, your symptoms would most likely continue.
Because the symptoms can be similar, doctors will often test for issues with your heart before giving you a diagnosis of POTS. “We make sure that the heart itself is structurally normal by performing an echocardiogram, which is an ultrasound of the heart,” says Dr. Brent P. Goodman, assistant professor and neurologist at the Mayo Clinic in Phoenix, Arizona.
Dr. Goodman says that regular testing for POTS includes other heart tests. “We will make sure that the intrinsic electrical system of the heart is functioning normally by performing an electrocardiogram, and sometimes with a longer recording called a Holter monitor.” A doctor may also perform a tilt-table test to see how your heart responds.
What causes tachycardia (rapid heart rate) in POTS?Healthline
The autonomic system, which is involved in controlling the body’s automatic functions, including heart rate and blood pressure, is believed by most to be the cause of tachycardia in POTS.Brent P. Goodman, MD, Assistant Professor of Neurology, Mayo ClinicAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.
While POTS and heart failure may share similar symptoms, Dr. Goodman says there’s no causal link. “POTS is not expected to contribute to or cause heart failure or other forms of heart disease.”
But that doesn’t mean that people with POTS shouldn’t be concerned about their heart health. “Of course, the fact that someone has POTS does not mean that they cannot develop heart disease due to other things that they may have or develop in the future.” Dr. Goodman cites diabetes and hyperlipidemia as two such conditions of concern.
There are a lot of medical conditions that can cause symptoms that are similar to POTS. For example, anemia, anxiety, and (more rarely) pheochromocytoma can all cause increased heart rates like POTS can.
The takeaway is that if you experience a racing heart and dizziness upon standing, don’t assume your symptoms are POTS and refrain from getting care. It’s important that a doctor rules out other possible causes (such as heart disease) so they can give you a diagnosis and help you manage your condition.
If your symptoms suddenly get much worse or are accompanied by chest pain, get immediate medical attention.
POTS also shares many symptoms with post-acute sequelae of COVID-19 (PASC), also known as long COVID. It’s unclear whether COVID can cause POTS, but research is ongoing. Talk with a doctor if you’re experiencing symptoms of POTS after having COVID-19.
A doctor may prescribe medications such as beta-blockers to lower your heart rate.
They may also prescribe medication to help keep up volume balance and lower the effects on your heart.
You can take several actions on your own to help manage POTS. Examples of
- Drink enough water and fluids daily to stay hydrated.
- Consume an appropriate amount of sodium daily to keep up your electrolyte balance.
- Rise slowly when you move from a sitting to a standing position.
- Wear compression stockings to help blood return to your heart. This can help you avoid fainting.
Overall wellness maintenance, such as getting enough rest and eating a healthy diet, can also help lower POTS symptoms. So can taking measures to lower stress whenever possible.
Keep in mind that you don’t need to be in an upright position for all exercise. Other options include:
- rowing machines
- recumbent bicycles
Other ways to improve heart health include refraining from smoking and eating a low-fat diet. Using this dietary approach can help you keep up a moderate weight.
The following are some frequently asked questions related to POTS, the heart, and heart disease.
Is POTS a type of heart disease?
Doctors call POTS a “
Is POTS life threatening?
POTS can be very scary, especially if you faint upon standing (about
Typically, the most significant risk to a person with POTS is the potential to fall and injure themselves during an episode of orthostatic intolerance.
Are beta-blockers safe for your heart?
A doctor may prescribe beta-blockers if you have POTS. Beta-blockers lower the effects of beta stimulation on the heart. Most noticeably, they decrease your heart rate, so your heart uses less oxygen and can pump more effectively.
Beta-blockers are generally safe and effective. They’re also prescribed by doctors to treat heart failure. They may help slow the progression of heart disease, but they won’t reverse existing heart failure.
But beta-blockers aren’t good for
POTS is a condition that causes your heart to beat more rapidly. But POTS isn’t a heart disease and isn’t likely to cause heart failure.
The fact that POTS isn’t life threatening doesn’t mean the condition isn’t debilitating for those who experience it. “POTS is an extremely common condition that predominantly affects women, and it should be prioritized,” stresses Dr. Goodman.
Talk with a doctor if you have POTS symptoms to determine how to lower your risk of falling and of acute episodes of POTS.