Pots Information Sheet Written by Pots Warrior (Aka Me)

POTS INFORMATION SHEET

What Is Postural Orthostatic Tachycardia Syndrome (POTS)?

· Postural orthostatic tachycardia syndrome (POTS) is a disorder that can make someone feel faint or dizzy. It happens when the autonomic nervous system doesn't work as it should. The autonomic nervous system is the body's "autopilot" system, controlling things like heart rate, blood pressure, and breathing.

· The autonomic nervous system problems seen in POTS — also called postural tachycardia (ta-kih-KAR-dee-uh) syndrome — can affect children and adults. Symptoms vary from mild to disabling.

What does POTS stand for?Postural: related to the position of your bodyOrthostatic: related to standing uprightTachycardia: increased heart rateSyndrome: a group of symptomsWhat Happens in POTS?· The autonomic nervous system keeps blood pressure at the right level for the brain no matter what position a person is in — standing (vertical), lying flat on the back (called supine), and sitting or reclining (called recumbent).· Usually when a person stands, the nerves of the autonomic nervous system tell blood vessels in the lower body to constrict (tighten). The tightening vessels work against gravity to keep blood from collecting in the legs. This automatic response makes sure the brain has enough blood flow to work well. If there is not enough blood flow to the brain, a person may feel lightheaded or pass out every time they stand. · In POTS, the autonomic nervous system doesn't work in the usual way, so the blood vessels don't tighten enough to make sure there is enough blood flow to the brain. To try to keep enough blood flowing to the brain, the autonomic nervous system makes the heart beat a lot faster instead.Why does heart rate increase excessively with POTS?In most patients with POTS, the structure of the heart itself is normal. POTS symptoms arise from a combination of the following:

· Lower amount of blood in the circulation

· Excessive pooling of blood below the level of the heart when upright

· Elevated levels of certain hormones such as epinephrine (also known as adrenaline since it is released by the adrenal glands) and norepinephrine (mainly released by nerves)

When we stand, gravity pulls more blood into the lower half of the body. In a healthy person, to ensure that enough blood reaches the brain, the body activates several nervous system responses. One such response is releasing hormones that help tighten blood vessels and cause a modest increase in heart rate. This leads to better blood flow to the heart and brain. Once the brain is receiving enough blood and oxygen, these nervous system responses settle back to normal.In people with POTS, for unclear reasons that may differ from person to person, the blood vessels don't respond efficiently to the signal to tighten. As a result, the longer you are upright, the more blood pools in the lower half of your body. This leads to not enough blood returning to the brain, which can be felt as light-headedness (faintness), brain fog and fatigue. As the nervous system continues to release epinephrine and norepinephrine to tighten the blood vessels, the heart rate increases further. This may cause shakiness, forceful or skipped heartbeats, and chest painSome people with POTS can develop hypotension (a drop in blood pressure) with prolonged standing (more than three minutes upright). Others can develop an Increase in blood pressure (Hypertension) when they stand. Types and Causes of POTS:

The causes of POTS vary from person to person. Researchers don't entirely understand the origins of this disorder. The classification of POTS is the subject of discussion, but most authorities recognize different characteristics in POTS, which occur in some patients more than others. Importantly, these characteristics are not mutually exclusive; person with POTS may experience more than of these at the same time:

Neuropathic POTS is a term used to describe POTS associated with damage to the small fibre nerves (small-fibber neuropathy). These nerves regulate the constriction of the blood vessels in the limbs and abdomen.