POTs Syndrome Causes, Triggers, & Diagnosis | Get Help with Heart2Heart


POTS is an abnormal increase in heart rate that occurs after sitting or standing up. It is most common in women aged between 15 years and 50 years.

Normally when you stand up your cardiovascular system responds to the change of position and the effort. This is the function of the autonomic nervous system in your body. In POTs this is not working properly. As a result when you stand up you have inadequate blood flow so your heart rate increases significantly to compensate. This causes the following symptoms

  • Dizziness or lightheadedness
  • Fainting
  • A brain fog
  • Palpitations
  • Fatigue
  • Weakness
  • Perspiration
  • Headaches
  • Nausea
  • Shortness of breath


POTs Syndrome Diagnosis:

There are a number of tests completed that will explore different reasons for your POTs symptoms

  • A tilt table test
  • Active stand test
  • Blood tests to test your liver, kidney and thyroid function
  • Electrocardiogram
  • Echocardiogram
  • 24-hour blood pressure and heart rate monitor

POTS Syndrome Treatment:

The European Society of Cardiology in 2019 issued the following guidelines for the treatment of POTS:

  • A regular progressive exercise programme should be considered (Level of evidence B)
  • The consumption of ≥2-3 L of water and 10-12g of sodium chloride daily may be considered (Level of evidence C)
  • Midorine, low- dose on non-selective betablocker, or pyridostigime may be considered (Level of evidence B)
  • Ivabridine may be considered (Level of evidence C)

At Heart 2 Heart we have travelled on the POTS journey with a number of our clients and here are our key findings

  • It can take quite a while for a diagnosis to be reached with those diagnosed experiencing significantly deteriorating capabilities over time
  • When reading about POTS many believe that the symptoms are minor but in severe cases, sufferers are bed bound for long periods with significant symptom onset on any position change and an extremely heavy fatigue burden
  • The journey to recovery is long and commitment to a rehabilitation programme is necessary with periods of recovery followed by relapses, on average a 2-3 relapse incidence over an 18 month period of rehabilitation.
  • If there is not a rigorous commitment to the prescribed exercise the effects of exercise training are limited. At Heart 2 Heart 2 offer weekly sessions but our clients are expected to complete 2 additional sessions themselves in their home initially and then in a gym or outdoor activity as they improve.
  • Unfortunately there is not quick fix and a continuum of exercise is required for the rest of their lives.
  • Significant lifestyle changes have to be addressed with POTS whether it means improved working hours, a good balance overall to maintain equilibrium.


Heart2Heart & POTS Treatment

Heart2Heart have developed a dedicated programme for patients in Ireland who have developed POTS, 


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