Medical Zebras

When you hear hoofbeats, think zebras, not horses.

 

Postural Orthostatic Tachycardia Syndrome (POTS) is a type of dysautonomia. It can result from damage to the brain stem due to cranial settling or Chiari 1 Malformation. Individuals with POTS experience loss of balance, lightheadedness, overheating, hyperventilation, palpitations, chest discomfort or pain, nausea, and/or fainting when upright. The autonomic nervous system cannot control heart rate, blood pressure, constriction of the blood vessels in the lower body, or respiration in individuals with POTS. When a person changes to an upright position, gravity begins to act upon their blood and pulls it to the lower half of their body. Most people's bodies adjust heart rate, constriction of blood vessels, and blood pressure to push the blood out of the lower body and up to the organs where it is needed. In an individual with POTS, this compensation does not occur and essential organs cannot get the blood they need while the individual is in an upright position. Upon returning to a neutral position, symptoms will subside, though it may take hours for them to do so.

 

                                                                           Quick Identification

Symptoms: fainting, palpitations, nausea, lightheadedness, overheating, hyperventilation, vomiting, chest discomfort or pain, headache, loss of balance, loss of sweating or excessive sweating, weakness, tremulousness, neuropathic pain, and/or abdominal pain when upright

Diagnosis: A tilt table test is the standard method for diagnosing POTS. A change in the patient's heart rate of 30 beats per minute (bpm) along with the patient's symptoms should be used for diagnosis.

 

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