POTS Syndrome Basics

What is POTS?

POTS stands for postural orthostatic tachycardia syndrome. Breaking POTS down based on its name can provide insight into the condition:

  • Postural means the condition is related to the posture of the body.
  • Orthostatic also suggests the body’s position is involved and refers to dizziness and a sudden drop in blood pressure.
  • Tachycardia means a rapid heartbeat, generally over 100 beats per minute.
  • Syndrome means it is not a disease but rather a group of symptoms that are often seen together.

POTS is characterized by a heart rate increase of 30 beats or more or a heart rate greater than 120, drop in blood pressure, and dizziness upon standing. This happens because the heart does not get enough blood when a person stands up, so the heartbeat increases to try to improve the blood circulation.

POTS is a type of dysautonomia, which are disorders of the part of the nervous system that regulates blood pressure, heart rate, and breathing patterns.


While POTS syndrome is characterized by the rapid rise in heart rate upon standing, a person with POTS may experience a wide variety of symptoms, including:

  • increased heart rate in the first 10 minutes of standing
  • drop in blood pressure
  • pain in hands and feet
  • lightheadedness
  • fatigue
  • heart palpitations
  • tremors or shaking
  • exercise intolerance
  • shortness of breath
  • chest pain
  • decreased ability to concentrate
  • pain or coldness in extremities
  • nausea
  • bloating
  • constipation
  • diarrhea
  • weakness

The combination of POTS symptoms varies from person to person. A person with POTS may have symptoms that range from mild to debilitating.

Causes and risk factors
Pregnanct woman at work, leaning on table because of pain and exhaustion.
If pregnancy causes POTS, the symptoms may subside after the pregnancy.
Scientists are not sure what causes POTS. However, some researchers believe that POTS may be more likely to occur right after the following events:

a pregnancy
severe illness or injury
major surgery
anything that causes changes in the function of the heart or blood vessels
damaged nerves or impaired nerve function in the feet or legs
prolonged periods of increased fight-or-flight responses
While researchers are still looking for the exact cause or causes of this condition, they have identified several underlying conditions and diseases that frequently occur in people with POTS.

These include the following:

  • autoimmune diseases
  • diabetes or prediabetes
  • deconditioning or prolonged bed rest
  • mononucleosis
  • Epstein Barr virus
  • Lyme disease
  • Ehlers Danlos syndrome
  • vitamin and mineral deficiencies, including anemia

While many people who develop POTS have no family history of the condition, some people who have POTS report a family history of conditions that result in an increased heart rate while standing. Because some people diagnosed with POTS have a family history of similar conditions, there may be a genetic component involved.
The majority of those diagnosed with POTS are women between age 15 and 50. However, POTS can affect people of any age or sex.