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Question:
I have Postural Orthostatic Tachycardia Syndrome? I have tried remedies the doctors have prescribed, including IV fluids, medicine and exercise. Can you recommend any other treatment?
What can help a pots (postural orthostatic tachycardia syndrome) patient? I have tried the hose, IV fluids, medicine, exercise… what they have said I have tried. I need help.
submitted by Hannah from Hawaii on 9/15/2014
Answer:
by Texas Heart Institute cardiologist, Michael J. Mihalick, MD
Dear Hannah:
This condition is often difficult to treat. Fortunately, the vast
majority of patients go into remission. It sounds like you have tried
some of the first line treatments. I suggest the following:
If you are
thin, or tall and thin you would benefit from a workout program to build
up your muscles, especially those in your legs. This is usually more
effective that support stockings, but it takes time, effort and
commitment.
You should increase your salt/sodium intake significantly.
Salt is good for you. Fluid intake is important, but your body will not
retain it without a corresponding intake of sodium.
As far as drugs are
concerned, I usually start with midodrine 5-10 mg 1 to three times a day
tailoring the strength and timing to your activity level and the time
of day your symptoms are likely to occur.
Beta blockers can help
significantly. Very high doses are often required, so unless limited by
heart rate or blood pressure constraints, the doses are frequently
higher than those used for hypertension.
I have little experience with
other drugs, but clonidine (a centrally acting blood pressure
medication), benzodiazepines (Valium family), and other neuro
psychiatric drugs such as Paxil and Prozac have been tried. In my
experience these latter drugs are likely to be of benefit if there is a
significant neuropsychiatric issue present.
I nothing above works, an
evaluation at a medical center that specializes in these problems would
be the next step.
I hope this will help.
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Updated September 2014
