What should you know about POTS and hypotension?

Postural orthostatic tachycardia syndrome, or POTS, causes symptoms when upright, such as dizziness, racing heartbeat, shakiness, blurred vision, fatigue or difficulty thinking. Blood pressure may remain stable, fall, or change in another pattern. Hypotension describes low blood pressure and can occur with dehydration, illness, medicines, bleeding or other conditions. Some people have both, but one label should not be assumed from dizziness alone.

Assessment usually compares pulse and blood pressure while lying down and after standing, alongside a history of triggers, fluid intake, fainting and medicines. Other causes may need consideration before a diagnosis is made.

Rise slowly, pause at the edge of the bed and sit or lie down if symptoms start. Avoid standing still for long periods and consider gentle movement of the calf and leg muscles. Keep a symptom diary showing posture, meals, heat, activity and recovery. Ask a clinician whether changes to fluids, salt, compression clothing, exercise or medicines are appropriate; these choices are not suitable for everyone, especially with heart or kidney conditions.

Get urgent help for chest pain, severe breathlessness, fainting with injury, a new irregular heartbeat, confusion, one-sided weakness or symptoms of serious bleeding. Arrange a prompt assessment for repeated near-fainting, falls, worsening exercise intolerance or dizziness that prevents ordinary activities.

Do my symptoms fit POTS, hypotension or another cause? Should pulse and blood pressure be measured in different positions? Which fluid, salt, exercise or medicine changes are safe with my health history?