Postural Orthostatic Tachycardia Syndrome: Symptoms, Diagnosis and Treatment

Feeling dizzy when you stand up, struggling with overwhelming fatigue or living with a racing heart can make everyday life feel unpredictable. If these symptoms sound familiar, you may have come across the term Postural Orthostatic Tachycardia Syndrome, often known as POTS.

At Westbourne Medical Studios, we know how frustrating it can be to live with symptoms that are difficult to explain. Many people with POTS spend months or even years searching for answers before receiving a diagnosis. We believe you deserve to be listened to, taken seriously and supported with compassionate, evidence-based care.

Our Clinical Director and family GP, Dr Veronica McBurnie, has a special interest in diagnosing and managing Postural Orthostatic Tachycardia Syndrome and other complex conditions that affect multiple body systems. Her approach is centred on understanding the whole person, not simply treating individual symptoms.

Because POTS often affects the cardiovascular system, we also have an experienced Consultant Cardiologist as part of our multidisciplinary team. Working together, we can provide comprehensive assessment and ongoing care, ensuring every aspect of your health is considered and that you receive joined-up, personalised treatment.

Postural Orthostatic Tachycardia Syndrome is a condition that affects the autonomic nervous system. This part of the nervous system controls many of the body's automatic functions, including heart rate, blood pressure, breathing and digestion.

When someone with POTS moves from lying down or sitting to standing, their heart rate increases much more than expected. This happens because the body struggles to regulate blood flow effectively. As a result, the brain and other organs may receive less blood for a short time, leading to a range of symptoms.

Although POTS can affect anyone, it is more commonly diagnosed in women and often develops during adolescence or early adulthood. It can also occur after a viral illness, surgery, pregnancy or periods of significant physical stress.

POTS affects everyone differently, and symptoms can vary from day to day. Some people experience occasional episodes, while others find their symptoms have a significant impact on daily life.

Common symptoms include:

• Dizziness or light-headedness when standing
• A rapid heartbeat or palpitations
• Feeling faint or fainting
• Extreme fatigue
• Brain fog and difficulty concentrating
• Shortness of breath
• Headaches
• Exercise intolerance
• Trembling
• Nausea and digestive problems
• Cold hands and feet
• Poor temperature regulation

Many people notice that symptoms become worse in warm weather, after standing for long periods, during illness or when they are dehydrated.

Because POTS affects several body systems, it can sometimes be mistaken for anxiety, chronic fatigue syndrome, panic attacks or other medical conditions.

Many patients tell us they have been reassured that their tests are normal, despite continuing to experience symptoms that affect work, education and family life.

Receiving the right diagnosis can provide reassurance, help explain what is happening and open the door to appropriate treatment.

Diagnosing POTS starts with listening carefully to your symptoms and understanding how they affect your daily life.

We take a detailed medical history and carry out a thorough assessment. This may include measuring your heart rate and blood pressure while lying down and standing, alongside blood tests and other investigations to rule out alternative causes of your symptoms.

In some cases, additional investigations such as a tilt table test may be recommended.

Dr Veronica McBurnie has extensive experience in assessing complex conditions such as POTS. She understands that diagnosis is about recognising patterns, considering associated conditions and taking the time to build a complete picture of your health. Where a specialist cardiac assessment is needed, our Consultant Cardiologist works alongside Dr McBurnie to investigate symptoms such as palpitations, dizziness and changes in heart rate, giving you access to expert care within one coordinated team.

POTS does not always occur on its own.

Some patients also have conditions such as Mast Cell Activation Syndrome (MCAS), hypermobile Ehlers-Danlos syndrome (hEDS), joint hypermobility, chronic fatigue and Long Covid.

Recognising these overlapping conditions is an important part of providing effective care. Looking at the whole picture allows us to develop a treatment plan that reflects your individual needs rather than focusing on one diagnosis in isolation.

Although there is currently no cure for Postural Orthostatic Tachycardia Syndrome, many people see a significant improvement with the right support and treatment.

Management may include:

• Increasing fluid intake
• Optimising salt intake where appropriate
• Compression garments
• Tailored exercise and rehabilitation programmes
• Medication to help regulate heart rate or blood pressure
• Identifying and managing symptom triggers
• Treating associated conditions where necessary

Every treatment plan is personalised. We work with you to understand your symptoms, lifestyle and goals, helping you regain confidence and improve your quality of life.

Living with POTS can be physically and emotionally challenging. Symptoms are often invisible to others, yet they can affect every part of daily life.

We believe healthcare should never feel rushed. We take time to understand your concerns, answer your questions and provide clear guidance throughout your diagnostic and treatment journey.

With Dr Veronica McBurnie's expertise in Postural Orthostatic Tachycardia Syndrome, we offer a thoughtful, evidence-based approach that focuses on long-term health rather than simply managing individual symptoms.

If you have been experiencing persistent dizziness, a racing heart or unexplained fatigue, we are here to help you find answers and support you every step of the way.

What causes Postural Orthostatic Tachycardia Syndrome?

The exact cause is not always known. POTS may develop after a viral illness, surgery, pregnancy or another significant physical event. In some people, it is associated with other medical conditions affecting the autonomic nervous system.

Can POTS be cured?

A: There is currently no cure, but many people experience significant improvement with the right diagnosis, lifestyle changes and personalised treatment plan.

Is POTS the same as low blood pressure?

No. While some people with POTS also experience changes in blood pressure, the condition is defined by an abnormal increase in heart rate when standing rather than low blood pressure alone.

When should I seek medical advice for POTS symptoms?

If you regularly experience dizziness, fainting, a racing heartbeat or severe fatigue when standing, it is worth seeking medical assessment. Early diagnosis can help you access the right support and improve your quality of life.