POTS: Connection to Heart Issues and Mental Health Concerns

POTS-related?

I have been seeing a psychiatrist for almost three years and have been on psychiatric medication during this time.
Recently, after experiencing fainting spells, I underwent cardiac-related examinations.
Initially, the doctor mentioned that it might be related to mitral valve regurgitation.
However, after observing a week's worth of blood pressure records, the doctor suggested that it seems more like Postural Orthostatic Tachycardia Syndrome (POTS), as my heart rate remains elevated, around 125 bpm while sitting, and sometimes reaching 130-140 bpm.

I have researched extensively online, but I found limited information on POTS in the last two years.
Instead, I came across panic disorder in related searches, and I noticed that the symptoms listed are quite similar to what I experience when my heart feels uncomfortable.
I would like to ask the doctor if POTS has been integrated into other medical conditions.
If not, how can I find relevant information to take preventive measures? If it is indeed related to panic disorder, should I consult my psychiatrist for a combined evaluation? Thank you for your assistance.

yxian, 20~29 year old female. Ask Date: 2021/01/13

Dr. He Dongjin reply Cardiology

Hello, Postural Orthostatic Tachycardia Syndrome (POTS) is caused by changes in posture.
The protective response is to slow down the action of standing up.
If your heart rate is 125 while sitting, it could be POTS or simply autonomic dysfunction.
It's hard to say, and it may be beneficial to consult a psychiatrist for further evaluation.
We pray for your well-being.
Changhua Hospital cares about you.

Reply Date: 2021/01/13

More Info

Postural Orthostatic Tachycardia Syndrome (POTS) is a condition that affects the autonomic nervous system, leading to an abnormal increase in heart rate when transitioning from lying down to standing up. It is characterized by symptoms such as lightheadedness, fainting, and rapid heartbeat, particularly upon standing. Your experience of elevated heart rates, especially while sitting, aligns with the symptoms of POTS, which can be exacerbated by anxiety and panic disorders.

The connection between POTS and mental health issues, such as anxiety and panic disorders, is well-documented. Many patients with POTS report symptoms of anxiety, and conversely, individuals with anxiety disorders may experience symptoms that mimic or exacerbate POTS. This overlap can create a complex interplay between physical and mental health, where anxiety can worsen POTS symptoms, and the physical symptoms of POTS can, in turn, increase anxiety levels.

Given your history of psychiatric treatment and the recent diagnosis considerations, it is essential to approach this situation holistically. Here are some steps you can take:
1. Consult with Your Healthcare Providers: It is crucial to maintain open communication with both your psychiatrist and your cardiologist. Discuss your symptoms in detail, including how they relate to your mental health. If POTS is suspected, your cardiologist may recommend specific tests, such as a tilt table test, to confirm the diagnosis.

2. Educate Yourself: While you mentioned that there is limited information available online regarding POTS, reputable medical websites and journals can provide valuable insights. Look for resources from organizations like the Dysautonomia International or the American Autonomic Society, which focus on autonomic disorders and can offer guidance on POTS.

3. Lifestyle Modifications: Managing POTS often involves lifestyle changes. Increasing fluid and salt intake can help expand blood volume and improve symptoms. Regular, gentle exercise, such as swimming or recumbent cycling, can also be beneficial. Additionally, wearing compression garments can help improve circulation and reduce symptoms.

4. Mental Health Management: Since anxiety can exacerbate POTS symptoms, it may be beneficial to address your mental health concurrently. Cognitive-behavioral therapy (CBT) has been shown to be effective for anxiety disorders and may help you develop coping strategies for both your anxiety and POTS symptoms. Discuss with your psychiatrist the possibility of integrating therapy into your treatment plan.

5. Medication Review: If you are currently on psychiatric medications, discuss with your psychiatrist whether any of these could be contributing to your symptoms. Some medications can affect heart rate and blood pressure, and adjustments may be necessary.

6. Monitoring and Follow-Up: Keep a detailed log of your symptoms, including heart rate, blood pressure, and any anxiety episodes. This information can be invaluable for your healthcare providers in tailoring your treatment plan.

7. Support Groups: Connecting with others who have POTS or similar conditions can provide emotional support and practical advice. Online forums and local support groups can be excellent resources.

In summary, POTS is a complex condition that can be intertwined with mental health issues. It is essential to work closely with your healthcare providers to address both the physical and psychological aspects of your health. By taking a proactive approach and utilizing available resources, you can better manage your symptoms and improve your overall well-being.

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