Postural Orthostatic Tachycardia Syndrome – Symptoms, Treatment

What is Postural Orthostatic Tachycardia Syndrome?

Postural Orthostatic Tachycardia is a syndrome where the patient is in upright condition the heart rate increases that will disable the person to do the daily activities. It normally affects women at any age, usually between 12-50 years of age. Tachycardia means there is an increase heart rate that in this disease the heart rate increases as fast as 30 beats per minute from supine position to standing up position that occurs within 30 minutes or less.

Postural Orthostatic Tachycardia Syndrome pics

Postural Orthostatic Tachycardia Syndrome in an Upright Position

What are the Symptoms?

  • Dizziness
  • Tolerance in exercise
  • The patient also experience extreme fatigue
  • Fainting
  • Excessive thirst is also experienced by the patient
  • Cold Extremities
  • Chest discomfort
  • The person become disoriented
  • Experience ringing of the ear
  • Shortness of breath
  • Headache
  • Muscle weakness
  • Visual disturbances
  • Abdominal pain
  • Diarrhea or Constipation
  • Nausea and Vomiting
  • Depression
  • Sleep disorder
  • The person has a difficulty in concentration

What Causes it?

There are different causes that will lead in the development of Postural Orthostatic Tachycardia Syndrome. The medical professionals must determine immediately the cause in order to avoid more problems. The causes that contribute to an individual Postural Orthostatic Tachycardia Syndrome are:

  • Adrenal Disorders like Addison’s disease. Addison’s disease is a disorder where there is a problem in the adrenal glands that usually produce the similar signs and symptoms of Postural Orthostatic Tachycardia Syndrome
  • Anemia or Folic Acid Deficiency that sometimes demonstrate the signs and symptoms of Postural Orthostatic Tachycardia Syndrome.
  • The patient release a certain enzyme called Angiotensin II receptor which is responsible in increasing the blood pressure of an individual.
  • Autoimmune disorders like Guillain-Barre and Lupus that can cause an individual having Postural Orthostatic Tachycardia Syndrome.
  • Cardiac Disease can lead in the development of Postural Orthostatic Tachycardia Syndrome.
  • Diabetes can also cause in the development of Postural Orthostatic Tachycardia Syndrome.
  • Liver Disease can also lead in the development of disease that coincides with hypovolemia and vasodialtion that the patient experiences.
  • Nutritional Deficiencies can also lead in the development of the disease. When an individual is lack on Vitamin B (1, 3, 6, 12) it can lead in the development of dysautonomia symptoms.
  • Syringomyelia is a type of disease where a cyst grows within the spinal cord that usually occurs between the age of 25 to 40. This disease also has similar signs and symptoms with Postural Orthostatic Tachycardia Syndrome.
  • Tumors that will lead patients in developing autonomic dysfunction that will affect the autonomic nervous system due to the compression.
  • Thyroid Disease that also had the similar signs and symptoms with Postural Orthostatic Tachycardia Syndrome.
  • Viruses can also provoke he development of the disease that can affect autonomic nervous system or it can affect the immunity of an individual.

How to Diagnose it?

Diagnosing this type of disease is difficult and it does need a continuous examination to determine the presence of this disease and to rule out other disease. The symptoms that are present must be check and considered before final diagnosis was made. There only one test that is vital in diagnosing this disease:

  • Tilt Table Test : it is used by medical professional to diagnose any diseases or malfunctioning of autonomic nervous system (dysautonomia) and it will also determine if the person experience lightheadedness or there is a lost in consciousness. It’s a procedure where the person will lie flat on a table and there are electrocardiogram (ECG) lines and blood pressure monitors that is connected to the patient that will test any changes when the patient change their posture from lying down to standing up.

Tilt Table Test pics

Tilt Table Test

How to Treat it?

Change in Diet

  • It is tested that drinking more water will help patients to improve symptoms
  • Avoid drinking alcohol due to its effect (vasodilation and dehydration) that will make the disease become worst
  • It is advised to eat in small frequent meals to reduce gastrointestinal symptoms that occur with patients with Postural orthostatic Tachycardia Syndrome
  • Adding recommended amount of salt or any electrolyte solution in the meals of the patient
  • It is also advised to eat low amount of carbohydrates that will help to improve the symptoms
  • Some patients are advised to have a “gluten free diet” that is found in foods that contain wheat because it can help in the improvement of symptoms
  • Caffeine in some patients can help to improve symptoms of this disease

Therapy and Exercise

  • Exercise will help to improve an individual to maintain muscle strength and to avoid deconditioning. It is advised that patients with this disease will start with low-intensity exercises first and gradually improve the intensity of the exercise. This will help the patients to improve symptoms of this disease.
  •  Tilting the head by 30 degrees angle can help to improve symptoms of Postural Orthostatic Tachycardia Syndrome


  • One of the noted symptoms of this disease is the lack of Vitamin B12, medical professionals give medication that contain vitamin B 12 for repletion of tissues.
  • Dietary supplement that contains sodium is recommended that will increase in blood volume and pressure.
  • Beta Blockers are also given to reduce the excessive increase in heart rate experienced by the patient who has this disease.
  • Medications used to treat orthostatic hypotension like Proamatine to stimulate vasoconstriction that will help to increase blood pressure and thus allow more blood to go back to the upper parts of the body.
  • Antidepressants like Prozac that is known for its effect in re-regulating the autonomic nervous system and it will also increase blood pressure.
  • Medications that treat for attention deficit like Ritalin will also cause vasoconstriction and increase in blood pressure.

Other Treatment

  • External Body Pressure by using pressure garments like abdominal binders and pressure stocking that will help to improve symptoms of the disease
  • Changes in the Environment can also affect and makes the disease worst like from indoor to outdoor environment or from sunny to rainy. Patient must be located to a place where there is a stable environment in order to avoid the disease to be worst.

Prognosis and Life Expectancy

People who have this disease usually recover completely. This disease must be treated immediately by medical professionals in order to achieve good recovery. This disease doesn’t reduce life expectancy but it can cause disability if the problems were not treated accordingly.

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