What is postural orthostatic tachycardia syndrome (POTS)?

Postural orthostatic tachycardia syndrome (POTS) is a collection of symptoms that is thought to be caused by a problem with body's adjustment of blood pressure and heart rate.

What are the symptoms of POTS?

Symptoms can include a racing heartbeat when changing to a standing position or with mild exercise, dizziness, fatigue, headaches, nausea and abdominal pain. It is most common in teenagers, and often occurs after an illness such as a virus, or a break in training for competitive athletes, but in many people, there is no clear cause. It is sometimes only a problem for a few months but sometimes it can last a year or longer.

How do doctors treat children with POTS?

Although we do not know what causes POTS, there are some things you can do that seem to make it better:

  • Adequate fluids. A tall glass of water or other fluid first thing in the morning, then reasonable drinking throughout the day is often very helpful. A goal of 80 oz. of fluid per day would not be unreasonable for an adult.
  • In many patients it is helpful to take additional salt. A good goal for an adult would be 1 tsp of salt (the same as 6 gm salt, 6000 mg salt, 2400 mg sodium, or 104 mEq sodium) per a day, either by adding some salt to your food or using salt supplements such as salt pills or specialty products that reduce stomach irritation such as Thermotabs ®or SaltStick® Vitassium. Supplements should be taken with meals.
  • Regular aerobic exercise every day may be the most important thing for long-term recovery, but it may take a few months and it is often difficult at the beginning. Jogging, swimming, jump rope, treadmill or sports such as basketball or soccer are all good choices. Exercise while seated or lying down may be easier in the beginning if exertion causes dizziness. Start with 5 minutes twice a day and add a few minutes each week until you can do at least 20-30 minutes each day.
  • Adequate sleep (8-10 hours per night) with the same bedtime every night. Cutting down on video screen exposure for 2 hours before bedtime may be important; if you can't avoid it, get some amber glasses to screen out the blue light spectrum or use the "night shift" setting on your iPhone® or iPad®.
  • A healthy, diverse diet, such as the DASH diet
  • If there are also problems with anxiety or depression, getting help with these may also have a beneficial effect on the symptoms of POTS
  • If the steps outlined above are not helpful enough to allow normal participation in life activities, it may be helpful in some people to use medications to reduce the symptoms of POTS.

Who can I contact if I have questions?

Please don’t hesitate to contact Pediatric Cardiology at Mass General for Children at 888-644-3248 if you have any additional questions about your child’s heart.

Rev. 8/2018. Mass General for Children and Massachusetts General Hospital do not endorse any of the brands listed on this handout. This handout is intended to provide health information so that you can be better informed. It is not a substitute for medical advice and should not be used to treatment of any medical conditions.