Postural tachycardia syndrome (PoTS)
Postural tachycardia syndrome (PoTS) is when your heart rate increases very quickly after getting up from sitting or lying down. It can get better with changes to your lifestyle, but some people may need treatment with medicines.
It's also known as postural orthostatic tachycardia syndrome.
Check if it's postural tachycardia syndrome (PoTS)
Certain symptoms of postural tachycardia syndrome (PoTS) happen when you stand up and get better when you lie down, such as:
- dizziness or light-headedness
- fainting or almost fainting
- noticeable heartbeats (heart palpitations)
- chest pain
- shortness of breath
- shaking and sweating
You may also get other symptoms, such as:
- problems with your stomach or digestion, such as feeling sick, being sick, diarrhoea, constipation, bloating and tummy pain
- headaches and problems with your sight, such as blurred vision or tunnel vision
- your hands and feet looking purple – this may be more difficult to see if you have brown or black skin
- weakness and extreme tiredness (fatigue), not being able to do much exercise, and sleeping badly
- problems with thinking, memory and concentration (brain fog)
These symptoms can be caused by other conditions, such as low blood pressure. Having them does not mean you definitely have PoTS.
Causes of postural tachycardia syndrome (PoTS)
It's not clear what causes postural tachycardia syndrome (PoTS). It can develop suddenly or gradually over time.
Some people have mild symptoms, while for others it can have a big impact on their everyday lives.
You may find your symptoms are worse in the morning, and they may change from day to day.
Some things can make your symptoms worse, such as:
- feeling hot
- eating, especially refined carbohydrates like white bread
- not drinking enough fluids
- drinking alcohol
- resting too much
- being on your period
Non-urgent advice: See a GP if:
- you have symptoms of postural tachycardia syndrome (PoTS)
How postural tachycardia syndrome (PoTS) is diagnosed
If you have symptoms of postural tachycardia syndrome (PoTS), a GP may check your blood pressure and heart rate before and after you stand up.
If they think you may have PoTS, they'll refer you to a specialist.
The specialist may perform more tests, such as:
- blood tests
- pee (urine) tests
- heart and blood pressure tests, such as an echocardiogram, ECG, and 24-hour blood pressure and heart rate monitoring
It can take time for people to be diagnosed with PoTS, as the symptoms are similar to other conditions.
Treatments for postural tachycardia syndrome (PoTS)
If you're diagnosed with postural tachycardia syndrome (PoTS), finding the right treatment for you can take time.
A specialist may suggest making changes to your lifestyle, such as eating and drinking at regular times and trying to manage stress, first.
You may also need to try several different medicines or combinations of medicines.
Things you can do if you have postural tachycardia syndrome (PoTS)
If you have postural tachycardia syndrome (PoTS), there are things you can try to help ease your symptoms.
If you suddenly feel faint or dizzy, you can try lying down and raising your legs until you feel better.
If you cannot lie down, you can try:
- crossing your legs with 1 in front of the other while standing
- rocking up and down on your toes
- clenching your buttocks and tummy muscles
- clenching your fists
Making changes to your lifestyle may also help with PoTS.
try to avoid the things that trigger your symptoms
drink plenty of fluids until your pee is pale
try gentle exercise, such as walking, jogging, pilates and swimming
raise the head of your bed so you're not lying completely flat
wear support tights to improve blood flow
do not stand up for too long
do not get up too quickly after lying down – sit for a while before standing up
do not drink too much caffeine or alcohol
Page last reviewed: 26 January 2023
Next review due: 26 January 2026