Does your heart race when you stand up?

Do you feel lightheaded when you stand?

If so read on…………………

I wanted to take this opportunity to tell you about a syndrome that we are finding more and more in people who come to participate in the research project at the Falls and Syncope Service at the RVI. PoTS is a condition that has been recognised for several years. One of the symptoms that patients with PoTS describe is fatigue with, in some patients, overwhelming fatigue being a chronic and persistent symptom. There are several papers in the medical literature that describe an overlap between CFS/ME and PoTS.

People with PoTS tend to describe a fast heart beat when they stand up or a feeling of palpitations when getting up from lying or sitting to standing. It is well recognised that PoTS is associated with problems with regulation of the autonomic nervous system but the most important thing is that there are treatments that we can try to improve the fast heart rate on standing up. In our experience this can have the advantage that in some patients it may also improve their symptoms including fatigue.

In the volunteers who are helping us with our research at the RVI we are finding PoTS in over 10%, so I strongly suspect it is an under recognised associate of fatigue. Other symptoms that patients with PoTS describe are shortness of breath in nearly 30%, chest wall pain in 25%, tremulousness in nearly 40% and some gastrointestinal symptoms in nearly a quarter. Almost 50% of those with PoTS experience fatigue, 32% sleep disturbance and 28% migrainous headache. Many of the patients who have been to see us in my clinic who we have diagnosed with PoTS are now being managed with medication but one of the most important messages for people with PoTS is that medication alone is unlikely to improve their fatigue, and that the whole package of a fatigue management programme in conjunction with the medication, is the most likely recipe for success.

Dr Julia Newton