POTS

  I would like to know what the Postural Orthostatic Tachycardia Syndrome is and how it affects sufferers please. I have tachycardia most mornings after getting out of bed, and always triggered in the shower (?heat, ? standing still) My heart goes around 180-190. I often feel dizzy and lightheaded, and have muscle fatigue if I lift my arms to wash my hair etc. This can come and go for several hours but rarely does it last past lunchtime. Strange I know. I am taking Tenormin 25mg daily which does not seem to do anything much except make me tired. I am 35 years old. I have other cardiac problems which I have written recently to you about, including LGL Syndrome, pacemaker (for second degree heart block) and this persistent tachycardia which seems to override the pacemaker. My doctor has never mentioned POTS but when I read about it it sounds like me. I would like to know more about it please. The tachycardia can come at other times of day, especially If I excert myself with exersize, but it seems strange how I always have it in the mornings and it comes for no apparent reason except getting out of bed. My blood pressure always runs on the low side, about 90/60.
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Dear Helen:
When some people change position (move from seated to standing position), their blood pressure falls dramatically and their heart rate climbs (or falls) inappropriately.  This can result in passing out, which can of course lead to serious injury.  The best way to diagnose this disorder is with a tilt-table test.  It is simple and relatively safe, done under monitored conditions.  It involves lying on a table that is moved to various angles.
You should see a cardiac electrophysiologist.  They are the doctors that perform tilt-table tests.
Information provided here is of a general nature.  Specific diagnoses and treatments can only be made by your doctor.  If you would like to be seen at the Cleveland Clinic, please call 1-800-CCF-CARE for an appointment with a cardiac electrophysiologist at Desk F15.