Exercise in the management of postural orthostatic tachycardia syndrome

Abstract

Postural Orthostatic Tachycardia Syndrome (POTS) is an autonomic dysfunction characterized by orthostatic symptoms including an increase in heart rate of at least 30 beats per minute (bpm) or reaching above 120 bpm soon after a postural change (Busmer, 2011). Symptoms include, but are not limited to, dizziness, nausea, palpitations, sweating, and fatigue. Twenty-five percent of those with POTS are unable to work (Busmer, 2013). One common pharmacologic treatment is beta-blockers (Lai et al 2009). There is little research into non-pharmacologic treatments, including exercise. The purpose of this case study was to determine if physical activity alleviates physical (heart rate) and psychological (depression and anxiety) symptoms of a patient with POTS. Following eight weeks of physical activity, the patient still met the diagnostic criteria of POTS. However, her quality of life improved based on the WHOQOL-100 AND HADS scores, and she reported being able to perform more tasks at home without feeling heart palpitations. The case study showed an improvement in quality of life for the participant with POTS, but minimal changes in heart rate response following standing post-intervention.