Help! Does this sound like POTS?

[Kai_sp]

I am 16 wks pregnant and in my 30s. No health issues except for anxiety for 3 about years now. Recently, I had hyperthyroid due to pregnancy which gave me bad palpitations (heart rate 100-150bpm). I was inactive for a month because of that, only standing to use the bathroom.  Now, my thyroid issues are resolved and resting heart rate has gone down (80s-90s), but when I stand up it can still go up to 140s. My doctor recommended drinking lots of fluid and increase salt intake. Weeks after my thyroid levels improved, and adding drinking more water, My mobility improved also. Also, I noticed some improvement in my standing heart rate. Sometimes time it goes up to 130-140 bpm still, but after about a minute or two goes back down to about 110-120 bpm. Sometime though, like after eating, it stays high. And sometimes, it just goes up to about 100-110 upon standing up. I have no other symptoms, besides the elevated heart rate upon standing. No passing out, dizziness, headaches, low bp, etc. All EKGs and Echo came back normal. I am also back to being almost fully functional after a month of bed rest. My cardiologist says it might be POTS, but she feels like it's more the pregnancy causing it. She says She cannot make any POTS diagnosis until after I deliver and take the tilt test. I am scared it might be POTS. Does this sound like POTS to you?

[Kai_sp]

Thank you so so much for your reply! I am so glad to know I am not the only pregnant person to have excessive elevated standing HR in pregnancy. I am almost convinced that this is pregnancy related due to not having other symptoms, but your reply really eased my anxiety and assured me that my doctors are probably right. I am truly hoping this will normalize after delivery.

Thank you also for the information about the salt. I will do that. I appreciate your replies. You do not know how much it means to me. May you be blessed always. Take care!

[Heiferly]

My sister had POTS-like elevated HR like you're experiencing when she was pregnant, and of course had the added risk factor of having a sister with a more severe, progressive form of autonomic disorder. Even with that, hers still ended up only being pregnancy related (thank God!) and she never had to see a specialist for it.

I don't recommend you worry about seeing a specialist for it at this point. Just keep an eye on it after you deliver and mainly watch for any new symptoms that might be indicative of POTS. In which case, seeing a specialist might be prudent.

You're welcome to keep us in mind as well. If you have any further concerns, I'll be happy to answer the to the best of my ability. I hope you have a happy and stress-free pregnancy!

(Just FYI, increasing salt with the increased water just improves your hydration. If you take in water alone it can throw off your electrolytes; the salt keeps your electrolytes up so your body will absorb the water instead of peeing it all out and flushing out important electrolytes. You can accomplish the same by drinking pedialyte or gatorade, but then you have to worry about all the artificial colors and flavors. I believe you can get pedialyte without artificial colors if you look for it.)

[Kai_sp]

Thanks for the replies. My cardiologist and ob gyn both feel like its more pregnancy related than POTS. I really do not have any other symptom BUT the increase in heart rate when standing and I can tolerate it pretty well. Honestly, it is the increase in heart rate that stresses me out, because from what I read, that's the 1st criteria for POTS. But my symptom is not very consistent. I only experience the elevated HR a few times a day (mostly when hungry or too full).  Most of the day, it is the normal rise.

I tried to increase salt intake but noticed that whether I take in more salt or not, nothing changes in my symptoms. I even lessened my water intake recently and I haven't noticed any difference either.

I am still optimistic that this is just pregnancy related and an effect of being deconditioned. I'm thinking of seeing a POTS doctor in my area, but I do not know if having only the elevated heart rate is enough to warrant that.

Any thoughts?

[Heiferly]

From the way your numbers are trending since you became more active and increased your water intake, it *looks* like it's not POTS and was more an issue with temporary deconditioning from your thyroid issue as well as changes in your body from being pregnant. So that looks optimistic!!

I notice you mention following your doctor's recommendation re: increasing fluid intake, but didn't mention increasing your salt intake? Have you been upping your sodium intake lately or no?

[nanasandy2]

It could be POTS, I have it and had many bouts of fainting, dizzy, lightheaded and the rise in heart rate on standing is usually the gold standard for it--but, do not worry so much, I am 68 and have had bouts of it for a year now--meds do help a lot, being the usual Midrodrine and Fludrocortisone to both help with the blood pressure.  You cannot take the steroid while pregnant, and I am not sure about the Midrodrine, but, you can get fitted or find medical compression stockings that are a help in keeping the blood from pooling in your legs, drinking water and keep hydrated, get up slowly, looking up and down too long can make you lightheaded---if you need a little support from me i am at this email~~~~one other thing~~~a cardiologist is the dr to see for this-- it is a heart rhythm thing, not heart disease at all, my heart and organs are healthy, as yours are probably too, but this is just a weird syndrome to have, and it goes away alot of times just as fast as it comes. Do not worry, you will be fine, and do not concentrate on it all day, just take care of yourself--i myself have been treated for anxiety and depression for 30 years now, so I know how you can feel at times. But, I am confident all will be fine for you, too. I have to be careful, yes, and take my BP 3-4 times a day, and walking is a good thing to do also.  Sandra