Postural orthostatic tachycardia syndrome (PoTS)

Postural orthostatic tachycardia syndrome (PoTS) is when your heart rate increases very quickly after getting up from sitting or lying down. Symptoms may ease with changes to your daily routine. Some people may need treatment with medicines.

Symptoms of PoTS

Symptoms of PoTS include:

• dizziness or light-headedness
• fainting or almost fainting
• a noticeably strong, fast heartbeat (palpitations)
• chest pain
• shortness of breath
• shaking
• sweating
• sleep disturbance

Some symptoms of PoTS happen when you stand up and get better when you lie down. You may also experience other symptoms, like:

• problems with your stomach or digestion, like feeling sick, being sick, diarrhoea, constipation and abdominal pain
• headaches
• extreme tiredness (fatigue)
• problems with your vision, like blurred vision or tunnel vision
• your hands and feet look blue – this may be more difficult to see if you have brown or black skin
• weakness and feeling of heaviness in legs and arms
• brain fog

Some people experience mild symptoms, while other people's symptoms can have a big impact on their daily life.

There are some factors that can make your symptoms worse, like:

• feeling too hot
• not drinking enough fluids
• eating, especially some forms of carbohydrates like white bread
• drinking alcohol
• resting too much
• exercise
• being on your period

Causes of PoTS

The causes of PoTS are not known. It can develop suddenly or gradually over time. It may happen after an infection like coronavirus (COVID-19) and flu.

How is PoTS diagnosed?

If you have symptoms of PoTS, a GP may check your blood pressure and heart rate before and after you stand up.

If they suspect you have PoTS, they may do further tests, like:

• blood tests
• urine test
• heart and blood pressure tests, like an echocardiogram, an ECG, and 24-hour blood pressure and heart rate monitoring

It may take some time for people to be diagnosed with PoTS, as the symptoms are similar to other health conditions. Your GP will be able to rule out other health conditions and may refer you to a specialist.

Find out more about how PoTS is diagnosed

Treatments for PoTS

If you're diagnosed with PoTS, finding the right treatment for you can take time.

A specialist may suggest making some practical changes to your daily routine like:

• changes to your diet
• pacing to manage and conserve your energy
• compression clothing for example support tights
• sleep management
• specialised exercise (discuss with your healthcare professional before starting)

You may also be prescribed medicines by your specialist to help control your symptoms, such as beta-blockers.

You may need to try several different medicines or combination of medicines.

Things you can do if you have PoTS

If you have PoTS, there are things you can do to help ease your symptoms.

If you're feeling faint or dizzy, you can try lying down and raising your legs until you feel better.

If you're unable to lie down, you can try:

• crossing your legs, with 1 leg in front of the other while standing up
• rocking up and down on your toes
• clenching your buttocks and stomach muscles
• clenching your fists

Making practical changes to your routine can also help relieve symptoms of PoTS.

PoTS and long COVID

PoTS is very common in long COVID.

There's a patient information booklet for people with long COVID.