HEALTHY LIVING


This COVID Leftover a Big Headache for Sufferers


Some have to wait 6 years for accurate diagnosis. ::


BY CHRIS ILIADES, M.D. S


ince COVID-19, cases of a chronic and often debilitating blood circulation disorder have risen sharply.


A new study from the University


of Toledo found postural orthostatic tachycardia syndrome (POTS) are up fivefold since March 2020. While POTS is now gaining more


widespread recognition, sufferers are often told their symptoms, such as lightheadedness upon standing and headaches, are just anxiety, and most have to wait approximately six years to get an accurate diagnosis. Doctors know what happens to people with POTS, but they are not sure why. The disorder may be triggered by COVID-19 or other viruses. “The best thing to happen to POTS


was COVID, because a significant number of people developed POTS after COVID, finally getting this condition the recognition it deserves, but it is still a diagnosis that many healthcare providers miss or misdiagnose,” says Kamal Raymond Chémali, M.D., professor of neurology at Case Western Reserve University.


SYMPTOMS POTS is a type of dysautonomia, which is an umbrella term for diseases of the autonomic nervous system, the part of your nervous system that controls body functions


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you don’t think about, including control of your heart and blood circulation, explains Chémali. When you stand up, gravity


pulls blood into your legs and abdomen, briefly reducing blood flow to the brain. Normally, hormones tighten the


blood vessels (vasoconstriction) to push blood back up. In POTS, the vessels don’t respond properly to the hormones, so blood pools in the lower body. The body then releases even more hormones, which drive the heart to beat too fast (tachycardia). Symptoms may include: Heart palpitations Chest pain Dizziness Passing or almost passing out


(syncope) Brain fog Blurred vision Headache Pale face and purple discoloration (mottling) of the lower legs Sweating and shaking Severe fatigue Nausea and vomiting


CAUSES Doctors are still unsure what causes POTS; however, one theory is that it may be an autoimmune disease, possibly triggered by a viral infection, such as COVID-19. Small-fiber neuropathy, a failure of the small


nerves that triggers vasoconstriction, is one such theory.


TREATMENT POTS is five times more common in women, usually starting between the ages of 15 and 30. “A history of feeling fine, especially


in a young woman, and then starting to have dizziness and tachycardia and other POTS symptoms when standing is a red flag,” says Chémali. While many tests can rule out other


causes, the only reliable diagnostic test is the tilt-table test. For the exam, you are secured to a


table while lying flat. The table is then raised to an almost upright position. Heart rate is assessed before


and after being raised. “If this test is normal, POTS is unlikely,” says Chémali. The main treatment for POTS is


increasing fluid and salt intake, which helps keep water in the bloodstream and allows more blood to reach the heart and brain. A compression garment that covers


the lower abdomen and upper legs may reduce blood pooling. It also helps to sleep with the entire head of the bed elevated, advises Chémali. Potentially beneficial medications


include drugs that constrict blood vessels, improve blood volume, help the kidneys retain salt, block certain hormones, or slow the heart rate.


PEPERMPRON/SHUTTERSTOCK


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