![]() The causes of POTS vary from person to person. Others can develop an increase in blood pressure (hypertension) when they stand. Some people with POTS can develop hypotension (a drop in blood pressure) with prolonged standing (more than three minutes upright). This may cause shakiness, forceful or skipped heartbeats, and chest pain. As the nervous system continues to release epinephrine and norepinephrine to tighten the blood vessels, the heart rate increases further. This leads to not enough blood returning to the brain, which can be felt as lightheadedness (faintness), brain fog and fatigue. As a result, the longer you are upright, the more blood pools in the lower half of your body. In people with POTS, for unclear reasons that may differ from person to person, the blood vessels don’t respond efficiently to the signal to tighten. Once the brain is receiving enough blood and oxygen, these nervous system responses settle back to normal. This leads to better blood flow to the heart and brain. One such response is releasing hormones that help tighten blood vessels and cause a modest increase in heart rate. ![]() In a healthy person, to ensure that a sufficient amount of blood reaches the brain, the body activates several nervous system responses. When we stand, gravity pulls more blood into the lower half of the body. POTS symptoms arise from a combination of the following:Įxcessive pooling of blood below the level of the heart when uprightĮlevated levels of certain hormones such as epinephrine (also known as adrenaline since it is released by the adrenal glands) and norepinephrine (mainly released by nerves). In most patients with POTS, the structure of the heart itself is normal. Why does heart rate increase excessively with POTS? Postural: related to the position of your body The key characteristics of POTS are the specific symptoms and the exaggerated increase in heart rate when standing. ![]() This branch of the nervous system regulates functions we don’t consciously control, such as heart rate, blood pressure, sweating and body temperature. POTS is a form of dysautonomia - a disorder of the autonomic nervous system.
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