Blood Volume Perturbations in the Postural Tachycardia Syndrome
Abstract
The postural tachycardia syndrome (POTS) is characterized by excessive orthostatic tachycardia with chronic symptoms that are associated with upright posture. These chronic symptoms (of at least 6 months' duration) include tachycardia, exercise intolerance, lightheadedness, extreme fatigue, headache, and mental clouding. Patients with POTS demonstrate an increase in heart rate of at least 30 beats/min within 5 to 30 minutes of assuming an upright posture, in the absence of orthostatic hypotension (a fall in blood pressure >20/10 mm Hg) and in the absence of other medical disorders that might cause tachycardia. POTS can be associated with a high degree of functional disability. The blood volume has been found to be low in many patients with POTS. This article will review some of the data regarding blood volume perturbations in POTS, blood volume regulation in POTS, and potential treatment approaches.
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In one study, more than 50% of POTS patients were noted to have loss of sweat function in distal lower extremities, measured as impaired sweat volume on quantitative sudomotor axon reflex testing or reduced intraepidermal C-fiber density on skin biopsy.
“In one study, >50% of POTS patients (6) were noted to have loss of sweat function in distal lower extremities (32), measured as impaired sweat volume on quantitative sudomotor axon reflex testing (32) or reduced intraepidermal C-fiber density on skin biopsy (33).”
From Postural Orthostatic Tachycardia Syndrome (2019) · cites this paper as [32]
Some POTS patients have persistently low plasma volumes, which evidence suggests is perhaps secondary to impaired function of the renin-angiotensin-aldosterone system.
“Some POTS patients have been noted to have persistently low plasma volumes (32,(42)(43)(44), which evidence suggests is perhaps secondary to impaired function of the renin-angiotensin-aldosterone system.”
From Postural Orthostatic Tachycardia Syndrome (2019) · cites this paper as [32]
Many POTS patients have decreased plasma volume.
“Many POTS patients have a decreased plasma volume (6–8) and high standing plasma norepinephrine (9).”
From Effect of High Dietary Sodium Intake in Patients With Postural Tachycardia Syndrome (2021) · cites this paper as [7]
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- Authors
- Raj, S. R., & Robertson, D.
- Affiliations
- Vanderbilt University (US)
- Corresponding author
- Raj, Satish R.
- ORCID
- Raj, Satish R.
- Venue
- The American Journal of the Medical Sciences
- Publisher
- Elsevier BV
- Published
- 2007-07
- Volume
- 334
- Issue
- 1
- Pages
- 57-60
- ISSN
- 0002-9629 (ISSN-L)
- OpenAlex
- W1995701496
- Cited by
- 80
- References
- 9
- Citations by year
- 2026: 3 · 2025: 5 · 2024: 3 · 2023: 4 · 2022: 3 · 2021: 5 · 2020: 6 · 2019: 4 · 2018: 3 · 2017: 1 · 2016: 7 · 2015: 4 · 2014: 5 · 2013: 4 · 2012: 6
- FWCI
- 2.99
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The American Journal of the Medical Sciences (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Center for Research Resources (K23RR020783)
- Topics
- Health Sciences › Medicine › Surgery › Cardiovascular Syncope and Autonomic Disorders
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
- Health Sciences › Medicine › Complementary and alternative medicine › Cardiovascular and exercise physiology
- Keywords
- postural orthostatic tachycardia syndrome, blood volume, orthostatic tachycardia, blood volume regulation, orthostatic intolerance, treatment options, functional disability
- MeSH terms
- Blood Pressure, Blood Volume, Fatigue, Heart Rate, Humans, Syncope, Syndrome, Tachycardia, Exercise Tolerance, Hypovolemia
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