Pure autonomic failure
Apr. 24, 2023
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Postural orthostatic tachycardia syndrome (POTS) is one of a group of disorders that have orthostatic intolerance as their primary symptom. Orthostatic intolerance is a condition in which an excessively reduced volume of blood returns to the heart after an individual stands up from a lying down position. The primary symptom of orthostatic intolerance is lightheadedness or fainting.
In postural orthostatic tachycardia syndrome, the lightheadedness or fainting is also accompanied by a rapid increase in heartbeat of more than 30 beats per minute, or a heart rate that exceeds 120 beats per minute, within 10 minutes of rising. The faintness or lightheadedness of postural orthostatic tachycardia syndrome is relieved by lying down again.
Anyone at any age can develop postural orthostatic tachycardia syndrome, but it mainly affects women between the ages of 15 to 50 years of age. Some women report an increase in episodes of postural orthostatic tachycardia syndrome right before their menstrual periods. Postural orthostatic tachycardia syndrome often begins after a pregnancy, major surgery, trauma, or a viral illness. It may make individuals unable to exercise because the activity brings on fainting spells or dizziness.
The cause of the disorder is unknown. Treatment is targeted at relieving low blood volume or regulating circulatory problems that may cause the disorder. A number of drugs seem to be effective in the short term. Whether they help in long-term is uncertain.
Simple interventions such as adding extra salt to the diet and attention to adequate fluid intake are often effective.
The drugs fludrocortisone (for those on a high salt diet) and midodrine in low doses are often used to increase blood volume and narrow blood vessels. Drinking 16 ounces of water (two glasses) before getting up can also help raise blood pressure. Some individuals are helped by beta receptor-blocking agents. There is some evidence that an exercise program can gradually improve orthostatic tolerance.
Postural orthostatic tachycardia syndrome may follow a relapsing-remitting course, in which symptoms come and go, for years. In most cases, an individual with postural orthostatic tachycardia syndrome improves to some degree and becomes functional, although some residual symptoms are common.
How can I or my loved one help improve care for people with postural tachycardia syndrome?
Consider participating in a clinical trial so clinicians and scientists can learn more about postural orthostatic tachycardia syndrome and related disorders. Clinical research uses human volunteers to help researchers learn more about a disorder and perhaps find better ways to safely detect, treat, or prevent disease.
All types of volunteers are needed—those who are healthy or may have an illness or disease—of all different ages, sexes, races, and ethnicities to ensure that study results apply to as many people as possible, and that treatments will be safe and effective for everyone who will use them.
For information about participating in clinical research visit NIH Clinical Research Trials and You. Learn about clinical trials currently looking for people with postural orthostatic tachycardia syndrome at Clinicaltrials.gov.
Where can I find more information about postural tachycardia syndrome?
Information may be available from the following resources:
Dysautonomia Youth Network of America, Inc.
National Dysautonomia Research Foundation
Content source: https://www.ninds.nih.gov/health-information/disorders/postural-tachycardia-syndrome-pots Accessed June 29, 2023.
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