POTS - Postural Orthostatic Tachycardia Syndrome

DEAR DR. DONOHUE: After multiple tests and visits to neurologists for symptoms similar to multiple sclerosis, one doctor finally recognized in our daughter the characteristics of postural orthostatic tachycardia syndrome -- POTS. She now sees a doctor who specializes in this disorder. Many others have told her that they too have the illness but suffered terribly until they obtained the correct diagnosis. Please let readers know how important this is. -- P.R.

ANSWER: POTS -- postural orthostatic tachycardia syndrome -- is a relatively new addition to the catalog of illnesses. It's something that happens most often to younger people between the ages of 14 and 45. The syndrome takes its name from one of its signs: the speeding up of the heart (tachycardia) upon standing (orthostatic). Other symptoms are dizziness and the feeling of being on the verge of fainting. People with the syndrome are tired all the time. They often suffer from nausea and stomach cramps. The trouble is a misfiring in the autonomic nervous system. It's the part of the nervous system not under our willful control. It operates on automatic pilot and takes care of such things as heartbeat regulation, blood pressure adjustments and the rate of breathing. In POTS, something has gone wrong with the chemical messengers of that underground nervous system. One diagnostic test is the tilt table test. The patient is strapped to a table that can be tipped 90 degrees vertically. When that is done, a person with POTS develops a very rapid heartbeat. Medicines can often alleviate symptoms and permit a person to live a normal life. One is fludrocortisone. It keeps blood volume on the high side to prevent the symptoms of POTS. Betablocker medicines are also effective. Aerobic conditioning, when supervised by a person experienced in this condition, is another important aspect of treatment.