POTS in Pregnancy

Postural Orthostatic Tachycardia Syndrome (POTS), first described in the 1940s, is a heterogeneous and often debilitating condition affecting the autonomic nervous system, estimated to affect between 0.3% and 1% of the U.S. population. Its incidence is believed to be rising among people with a prior COVID-19 infection, as a likely component of so-called long COVID. The condition is characterized by chronic orthostatic intolerance in the absence of orthostatic hypotension manifested as excessive increased heart rate upon standing. The etiology is not well understood but is thought to be complex. One recent publication described the complex etiology of POTS as, “A multitude of pathophysiologic mechanisms including but not limited to disproportionate sympathoexcitation, volume depletion, autoimmune dysfunction, cardiac and physical deconditioning point to a heterogeneously complex etiology”. Other POTS symptoms include fatigue, headaches, cognitive impairment, palpitations, chest pain and gastrointestinal symptoms. These symptoms can significantly reduce quality of life. Interestingly, most people with POTS are under age 50. In this episode we will review POTS in pregnancy. What therapies are available? Does anxiety have a role within this process? Listen in for details.