A Simple Guide to Postural Tachycardia Syndrome, Diagnosis, Treatment and Related Conditions

By Kenneth Kee

This book describes Postural tachycardia syndrome, Diagnosis and Treatment and Related Diseases which is seen in some of my patients in my Family Clinic.

"My heart beats very fast when I stand to greet my fair lady so let me sit or lie down before I faint"

That sums up what postural tachycardia is about.

Postural tachycardia syndrome (POTS) is now recognized to be fairly common disorder which has treatment methods that can result in a considerable improvement in the quality of life.

Postural tachycardia syndrome (POTS) is a common disorder characterized by an abnormal increase in heart rate (tachycardia) upon standing up but often misdiagnosed.

Generally when a person stands up, blood vessels in the lower body constrict to prevent blood from pooling in the legs and maintain blood flow to the brain.

This disorder also known as postural orthostatic tachycardia syndrome is linked with a wide range of symptoms that can affect a person's quality of life.

In persons with POTS, this autonomic nervous system reaction does not function properly, leading to inadequate blood flow to the brain and compensatory increases in heart rate.

This branch of the nervous system controls functions that people do not consciously regulate such as heart rate, blood pressure, body temperature and sweating.

Postural tachycardia syndrome symptoms begin from a combination of these:
Lower amount of blood in the circulation
Excessive drop of blood volume below the level of the heart when upright
Elevated levels of certain hormones such as epinephrine and nor-epinephrine.

When a person stands, the force of gravity draws more blood into the lower half of the body.

In a healthy person, the body triggers several nervous system reactions to ensure that an adequate quantity of blood reaches the brain.

One such reaction is releasing epinephrine and nor-epinephrine that help constrict blood vessels and induce a rise in heart rate resulting in a better blood flow to the heart and brain.

Once the brain has received sufficient blood and oxygen, the nervous system reactions go back to normal.

In people with postural tachycardia syndrome, the blood vessels do not react effectively to the signal to constrict for reasons that may differ from person to person.

As a result, the longer the person is upright, the more blood drops down the lower half of the body.

This stops adequate blood going back to the brain which can be sensed as lightheadedness, brain fog and fatigue.

The epinephrine and nor-epinephrine may produce tremors, forceful or skipped heartbeats and chest pain.

Some people with postural tachycardia syndrome can have a drop in blood pressure (hypotension) with extended standing (more than 3 minutes upright).

The precise causes of POTS are not fully known, and it can be a complicated and multi-factorial disorder

The head-up tilt table (HUT) with non-invasive hemodynamic monitoring is the gold standard for evaluating orthostatic intolerance in POTS.

POTS patients will normally have an increase in heart rate of >30 beats per minute in response to the tilt testing.

Treatment for POTS focuses on symptom management and improving quality of life.
Lifestyle modifications:
Drinking plenty of fluids, increasing salt intake and gradually increasing physical activity levels
Medicines:
Beta-blockers, fludrocortisone, and other medicines may be prescribed to help regulate heart rate and blood pressure.
Psychological support:
Counseling or therapy to treat anxiety, depression, and coping with chronic illness.

TABLE OF CONTENT
Introduction
Chapter 1 Postural Tachycardia Syndrome
Chapter 2 Cause
Chapter 3 Symptoms
Chapter 4 Diagnosis
Chapter 5 Treatment
Chapter 6 Prognosis
Chapter 7 Poor Posture
Chapter 8 Postural Digestive Disorder
Epilogue

• Language: English
• Publisher: Kenneth Kee
• Release date: Jul 6, 2023
• ISBN: 9798215711880

Kenneth Kee

Medical doctor since 1972.Started Kee Clinic in 1974 at 15 Holland Dr #03-102, relocated to 36 Holland Dr #01-10 in 2009.Did my M.Sc (Health Management ) in 1991 and Ph.D (Healthcare Administration) in 1993.Dr Kenneth Kee is still working as a family doctor at the age of 74However he has reduced his consultation hours to 3 hours in the morning and 2 hours inthe afternoon.He first started writing free blogs on medical disorders seen in the clinic in 2007 on http://kennethkee.blogspot.com.His purpose in writing these simple guides was for the health education of his patients which is also his dissertation for his Ph.D (Healthcare Administration). He then wrote an autobiography account of his journey as a medical student to family doctor on his other blog http://afamilydoctorstale.blogspot.comThis autobiography account “A Family Doctor’s Tale” was combined with his early “A Simple Guide to Medical Disorders” into a new Wordpress Blog “A Family Doctor’s Tale” on http://ken-med.com.From which many free articles from the blog was taken and put together into 1000 eBooks.He apologized for typos and spelling mistakes in his earlier books.He will endeavor to improve the writing in futures.Some people have complained that the simple guides are too simple.For their information they are made simple in order to educate the patients.The later books go into more details of medical disorders.He has published 1000 eBooks on various subjects on health, 1 autobiography of his medical journey, another on the autobiography of a Cancer survivor, 2 children stories and one how to study for his nephew and grand-daughter.The purpose of these simple guides is to educate patient on health disorders and not meant as textbooks.He does not do any night duty since 2000 ever since Dr Tan had his second stroke.His clinic is now relocated to the Buona Vista Community Centre.The 2 units of his original clinic are being demolished to make way for a new Shopping Mall.He is now doing some blogging and internet surfing (bulletin boards since the 1980's) startingwith the Apple computer and going to PC.The entire PC is upgraded by himself from XT to the present Pentium duo core.The present Intel i7 CPU is out of reach at the moment because the CPU is still expensive.He is also into DIY changing his own toilet cistern and other electric appliance.His hunger for knowledge has not abated and he is a lifelong learner.The children have all grown up and there are 2 grandchildren who are even more technically advanced than the grandfather where mobile phones are concerned.This book is taken from some of the many articles in his blog (now with 740 posts) A Family Doctor’s Tale.Dr Kee is the author of:"A Family Doctor's Tale""Life Lessons Learned From The Study And Practice Of Medicine""Case Notes From A Family Doctor"

Book preview

A

Simple

Guide

To

Postural Tachycardia Syndrome,

Diagnosis,

Treatment

And

Related Conditions

By

Dr Kenneth Kee

M.B., B.S. (Singapore)

Ph.D (Healthcare Administration)

Copyright Kenneth Kee 2023 Smashwords Edition

Published by Kenneth Kee at Smashwords.com

Dedication

This book is dedicated

To my wife Dorothy

And my children

Carolyn, Grace

And Kelvin

This book describes Postural tachycardia syndrome, Diagnosis and Treatment and Related Diseases which is seen in some of my patients in my Family Clinic.

(What You Need to Treat Postural tachycardia syndrome)

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If you’re reading this book and did not purchase it, or it was not purchased for your use only, then please return to Smashwords.com and purchase your own copy.

Thank you for respecting the hard work of this author.

Introduction

I have been writing medical articles for my blog: http://kennethkee.blogspot.com (A Simple Guide to Medical Disorder) for the benefit of my patients since 2007.

My purpose in writing these simple guides was for the health education of my patients.

Health Education was also my dissertation for my Ph.D (Healthcare Administration).

I then wrote an autobiography account of my journey as a medical student to family doctor on my other blog: http://afamilydoctorstale.blogspot.com.

This autobiography account A Family Doctor’s Tale was combined with my early A Simple Guide to Medical Disorders into a new Wordpress Blog A Family Doctor’s Tale on http://kenkee481.wordpress.com.

From which many free articles from the blog was taken and put together into 800 eBooks.

Some people have complained that the simple guides are too simple.

For their information they are made simple in order to educate the patients.

The later books go into more details of medical disorders.

The first chapter is always from my earlier blogs which unfortunately tends to have typos and spelling mistakes.

Since 2013, I have tried to improve my spelling and writing.

As I tried to bring the patient the latest information about a disorder or illness by reading the latest journals both online and offline, I find that I am learning more and improving on my own medical knowledge in diagnosis and treatment for my patients.

My diagnosis and treatment capability has improved tremendously from my continued education.

Just by writing all these simple guides I find that I have learned a lot from your reviews (good or bad), criticism and advice.

I am sorry for the repetitions in these simple guides as the second chapters onwards have new information as compared to my first chapter taken from my blog.

I also find repetition definitely help me and maybe some readers to remember the facts in the books more easily.

I apologize if these repetitions are irritating to some readers.

Chapter 1

Postural tachycardia syndrome (POTS)

What is Postural tachycardia syndrome?

Postural tachycardia syndrome (POTS) is a common disorder characterized by an abnormal increase in heart rate (tachycardia) upon standing up but often misdiagnosed.

Generally when a person stands up, blood vessels in the lower body constrict to prevent blood from pooling in the legs and maintain blood flow to the brain.

This disorder also known as postural orthostatic tachycardia syndrome is linked with a wide range of symptoms that can considerably affect a person's quality of life.

In persons with POTS, this autonomic nervous system reaction does not function properly, leading to inadequate blood flow to the brain and compensatory increases in heart rate.

Postural tachycardia syndrome is a disorder of dysfunction of the autonomic nervous system.

This branch of the nervous system controls functions that people do not consciously regulate such as heart rate, blood pressure, body temperature and sweating.

The main features of POTS are the specific symptoms and the excessive increase in heart rate when standing.

In most patients with postural tachycardia syndrome, the structure of the heart itself is normal.

Postural tachycardia syndrome symptoms begin from a combination of these:

1. Lower amount of blood in the circulation

2. Excessive drop of blood volume below the level of the heart when upright

3. Elevated levels of certain hormones such as epinephrine (also termed adrenaline since it is released by the adrenal glands) and nor-epinephrine (mainly released by nerves).

When a person stands, the force of gravity draws more blood into the lower half of the body.

In a healthy person, the body triggers several nervous system reactions to make sure that an adequate quantity of blood reaches the brain.

One such reaction is releasing hormones (epinephrine, nor-epinephrine) that help constrict blood vessels and induce a rise in heart rate resulting in a better blood flow to the heart and brain.

Once the brain has received sufficient blood and oxygen, the nervous system reactions go back to normal.

In people with postural tachycardia syndrome, the blood vessels do not react effectively to the signal to constrict for reasons that may differ from person to person.

As a result, the longer the person is upright, the more blood drops down the lower half of the body.