A Neurological Disorder Known as POTS Can Cause Dizziness and Fainting

Lack of awareness and inadequate treatment causes many to struggle needlessly with a debilitating disorder called POTS. Lightheadedness and/or fainting spells upon standing are a common symptom. Not enough blood returns to the heart and brain upon standing, which causes a rapid increase in heart rate called tachycardia. Other symptoms may include chronic fatigue, “brain fog,” and pain.

By: Amy Paturel.

Jenna BockWhen 20-year-old Jenna Bock left her home in Oak Park, CA, to attend college in Wisconsin, she had visions of freedom and fraternity parties. Those dreams evaporated in November of her freshman year when she was hospitalized with the flu. A few weeks later, after watching a movie in her friend’s dorm room, she stood up and promptly passed out.

“I thought it was a fluke, but a couple of days later, it happened again. By January, I was fainting up to 10 times a day,” says Bock, a busy college student who was active in campus government and worked as an intern for a counseling service.

Bock visited dozens of physicians and spent weeks hospitalized with various ailments, yet no one could identify the cause of her symptoms. Some doctors even claimed she was making it up. Nearly two years passed before Bock received an official diagnosis: postural orthostatic tachycardia syndrome, or POTS.

Bock’s fainting spells are one of the hallmarks of POTS. Another is trouble standing up, primarily because not enough blood returns to the heart upon standing, which causes a rapid increase in heart rate called tachycardia. In fact, the diagnostic criteria for this syndrome include an increase in heart rate of more than 30 beats per minute (40 beats per minute for children) or a heart rate of 120 beats per minute within 10 minutes of standing. Other symptoms include chronic fatigue, “brain fog,” and pain.

To confirm her diagnosis, doctors monitored Bock’s heart rate and blood pressure while moving her from a horizontal to a vertical position on a special tilting table. Unfortunately, once Bock tested positive during this “tilt table test,” doctors still didn’t know how to help her.

HIDING IN PLAIN SIGHT

Even though Mayo Clinic researchers coined the term “POTS” in 1993, many physicians have never seen the condition in their practice, or at least have not identified it accurately, in part because there are so many accompanying symptoms that can be mistaken for something else.

Despite the lack of awareness, POTS isn’t rare, explains Svetlana Blitshteyn, MD, clinical assistant professor of neurology at the University at Buffalo School of Medicine and director of the Dysautonomia Clinic in Buffalo, NY. “It’s estimated that between 1 and 3 million Americans are affected by the syndrome.” POTS can strike at any age, but it primarily affects women between the ages of 15 and 50 who, like Bock, are in the prime of their lives. These active, vibrant, productive members of society are incapacitated, sometimes abruptly and for long periods of time.

Now, with a greater understanding of POTS and its many co-existing conditions, scientists are working to unravel this mysterious illness.

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