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POSTURAL ORTHOSTATIC TACHYCADIA SYNDROME (POTS)

PoTS is a disorder that has orthostatic intolerance as its most common symptom. When you have POTS, most of your blood stays in the lower part of your body when you stand up. Subsequently, this makes your heart beat faster to try and increase blood to your brain. As this happens your blood pressure can drop causing you to feel dizzy, blurry vision, nausea, vomiting or brain fog. Symptoms can occur with prolonged standing, feeling stressed or after eating.

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The cause for PoTS is still unclear. It is felt to impact between 1-3 Million Americans. However, there has been recent evidence that PoTS may be caused by Pelvic Venous Insufficiency or Pelvic Congestion Syndrome.

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SIGNS

INCREASE IN HEART RATE BY 30 BPM OVER 120 BPM WITHIN THE FIRST 10 MINUTES UPON STANDING WITHOUT ORTHOSTATIC HYPOTENSION

POSITIVE TILT TABLE TEST

SYMPTOMS

                               EXTREME TIREDNESS

                               DIZZINESS WHEN STANDING

                               LIGHTHEADEDNESS

                               HEART PALPITATION

                               SHORTNESS OF BREATH

                               ANXIETY

                               NAUSEA

                               BLURRED VISION

                               POOR CONCENTRATION

TREATMENT OPTIONS

HOW IS POTS SYNDROME DIAGNOSED

At Advanced Vein Solutions and Cardiovascular Health Clinic we are composed of vascular specialist and cardiologist who are trained in the diagnosis and treatment of PoTS.

TREATMENT OPTIONS

Typical treatment options include:

  • Increasing fluid intake

  • Increasing salt consumption

  • Wearing Compression Stockings

  • Raising the head of the bed

  • Avoiding substances and situation that worsen symptoms

  • Numerous different medications

WHAT ABOUT PELVIC CONGESTION SYNDROME?

If you suffer from PoTS syndrome, there is recent data that suggest symptoms may be secondary to pelvic congestion syndrome, aka pelvic venous insufficiency. We have found that many patients have May-Thurner, venous compression syndrome, causing varicosities within the pelvis and pooling of blood. This pooling of blood in the pelvis may make it difficult to obtain adequate blood return to the brain causing associated symptoms. We have found a high success rate of treating PoTS upon treatment of underline pelvic venous insufficiency.

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Evaluation involves clinic consultation followed by CT of the abdomen and pelvis. If underlying May-Thurner and pelvic varicosities are demonstrated, patient will undergo pelvic venogram with treatment of underlying venous disease which may include, stenting of common iliac vein stenosis and/or embolization of abnormal varicose veins within the pelvis.

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