![]() Patients commonly suffer from cognitive dysfunction, sleep disturbances and exercise intolerance. This leads to cramping and colicky-like pains (Fischer, 2007). The body is attempting to digest food when there is no food to digest. For a smaller percentage of patients, the trouble is that there is too much blood in parts of the intestines. As a result, these people have trouble with nausea. The problem is that blood flow is not matching the need, so blood is not going to the right part of the intestinal system when it needs to. For example, around one third to one-half of POTS patients have digestive troubles (Fischer, 2007). A patient experiencing ANS dysregulation may experience abnormalities in the many organs and functions the ANS regulates. Some of these functions include temperature, respiration, pupil dilation and constriction, salivation and the digestive tract. The autonomic nervous system is responsible for regulating a multitude of organs and functions throughout the body. In people with POTS, the system seems to be out of balance and blood is not going to the right place at the right time to do what the body needs (Fischer, 2007). Some of the messages coming from the autonomic nervous system tell the blood vessels to relax or tighten. It is the autonomic nervous system (ANS) that regulates the needed adjustments in vascular tone, heart rate and blood pressure upon standing. Many POTS symptoms seem to be caused by an imbalance of the Autonomic Nervous System's (ANS) control over blood flow. ![]() While the hallmark of POTS is an excessive heart rate increment upon standing, patients often exhibit numerous symptoms of autonomic nervous system dysregulation, and research by the Mayo Clinic suggests POTS is a limited autonomic neuropathy (Thieben, Sandroni, Sletten, Benrud-Larson, Fealey, Vernino, Lennon, Shen & Low, 2007). In patients < 19 years of age, there is a higher HR threshold for POTS (increment ≥ 40 bpm or absolute uprights HR ≥ 120 bpm) due to physiological orthostatic tachycardia in adolescents and children (Singer et al., 2012) (Arnold, Ng, Raj, 2018) The criteria for diagnosis of POTS is: (1) a sustained increase in HR of at least 30 bpm within 10 minutes of standing (often with an absolute upright HR ≥ 120bpm) (2) in the absence of sustained orthostatic hypotension (drop in BP > 20/10mm Hg) (3) with symptoms of orthostatic intolerance for at least 6 months. POTS is a disorder that is a part of the dysautonomia family of disorders. Postural orthostatic tachycardia syndrome (POTS) is a disorder characterized by orthostatic intolerance. ![]() When the body cannot effectively adjust to upright posture, a person is said to have orthostatic intolerance. There are disorders that affect the body's ability to appropriately adjust to the pull of gravity. ![]() However, the simple act of standing up can be a challenge for some people. Our bodies operate in perfect homeostasis and we stand up with little effort. Blood vessels contract, heart rates increase and our systolic blood pressure remains the same or decreases slightly while diastolic pressure increases slightly (Brunner & Suddarth, 2000, p. Our bodies automatically adjust to the pull of gravity by increasing vascular tone, heart rate, and cardiac output. Standing up is something most of us take for granted we've been doing it since childhood. An overview of Postural Orthostatic Tachycardia Syndrome
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