

Answer to Medical Mystery Monday #115

The answer to yesterday’s mystery is … Postural Tachycardia Syndrome (POTS)! Wonderful job to readers Mrs. Mac, O’B1, colleen (with a little c), Angela, k, Rich S, Alexandra Zimmerman, Dave, kelli, Mike, LG. Though a common answer was some form of hypotension, note that this patient’s blood pressure does not decrease upon standing.

POTS is a disease of the sympathetic nervous system, often referred to as the “fight-or-flight” response, most prevalent in young women. For an unknown reason, the fight-or-flight nerves become overactivated when patients with POTS stand up. Upon standing, these patients may feel their heart racing, anxiety, blurred vision, lightheadedness, and weakness. Because the sympathetic nervous system also controls motion of the intestines, patients with POTS can have gastrointestinal symptoms like nausea, bloating, and constipation as well.

POTS is diagnosed with the tilt-table test, which was depicted in yesterday’s post. Patients are tilted from lying to upright, and a sustained accompanying increase in heart rate by 30 beats per minute is diagnostic of POTS. There is no definitive treatment, but patients are encouraged to drink plenty of water and maintain a high-salt diet. These measures ensure the volume of blood remains high, which inhibits a fast heart rate. Some patients have found medication to slow the heart helpful, such as beta blockers.

Hope you liked reading about POTS disease! Do you have an idea for a medical mystery? If so, email me at mdtobeblog (at) gmail (dot) com.

Marianne DiNapoli