Postural Tachycardia Syndrome
Postural Tachycardia Syndrome (PoTS) is when the autonomic nervous system (ANS) malfunctions. This is sometimes called ‘dysautonomia’. The ANS is in charge of all bodily functions that we don’t have to think about e.g:
Heart rate and blood pressure regulation, digestion, bladder control, sweating, stress response.
When a healthy person stands up, blood vessels narrow, and heart rate increases slightly to maintain blood supply to heart and brain.
In PoTS, this adjustment is not working correctly, causing an excessive rise in heart rate, increased stress hormones in the blood and altered blood flow to the brain.
Management is through salt intake, sometimes medication, compressive garments, progressive rehabilitation (often by starting in lying) and breathing exercises.
A study by Reilley, 2020, found that 80-90% of patients with PoTS that went to a respiratory physiotherapist had a breathing pattern dysfunction.
Another study by Loughlan, 2020, found that exercise intolerance in PoTS was more likely due to breathing pattern dysfunction than problems with the heart or blood vessels.