Postural Orthostatic Tachycardia Syndrome (POTS) is a condition that affects blood circulation and the autonomic nervous system, which controls involuntary bodily functions like heart rate and blood pressure regulation. It is characterized by an abnormal increase in heart rate when moving from a lying to an upright position. While a medical diagnosis is necessary, this article offers guidance on preliminary at-home assessment methods that may prompt professional consultation.
Recognizing POTS Symptoms
Individuals considering at-home testing for POTS often experience symptoms that worsen when upright and tend to improve upon lying down. Common manifestations include lightheadedness, dizziness, near-fainting, or fainting episodes. A rapid heart rate upon standing is a common symptom, often accompanied by palpitations.
Many people also report fatigue and a sensation of “brain fog,” involving difficulty concentrating or remembering. Other symptoms can include exercise intolerance, headaches, blurry vision, nausea, excessive sweating, and shakiness. These symptoms arise because the body’s automatic adjustment to upright posture does not function correctly in individuals with POTS, leading to an exaggerated heart rate increase and altered blood flow.
Performing the Home Lean Test
The “Poor Man’s Tilt Table Test” or “NASA Lean Test” is a common at-home method to assess for POTS. Find a quiet, comfortable space where you can lie down for 10 minutes to establish a stable baseline. During this resting period, be relaxed and still, avoiding distractions, eating, drinking, or intense physical activity beforehand.
After resting, measure your heart rate and blood pressure while still lying down. A reliable blood pressure monitor that measures heart rate is recommended. If your device does not measure heart rate, you can manually check your pulse by counting beats for 30 seconds and multiplying by two to get beats per minute (BPM). Record these baseline measurements.
Slowly stand up and position yourself upright against a wall, ensuring only your shoulder blades touch the wall and your heels are approximately six to eight inches away. Remain as still and relaxed as possible. It is helpful to have another person present to assist with measurements and to ensure safety, especially if you feel unwell.
While standing, measure your heart rate and blood pressure at 1, 2, 5, and 10 minutes. Record each set of measurements, noting any symptoms experienced, such as lightheadedness, dizziness, or palpitations. If you feel dizzy or as though you might faint, stop the test immediately and lie down.
Understanding Your Home Test Results
Interpreting your home lean test measurements focuses primarily on the change in heart rate upon standing. For adults, a sustained increase of 30 beats per minute (bpm) or more within 10 minutes of standing, compared to your resting heart rate, is a common indicator warranting further investigation for POTS. For adolescents aged 12 to 19, a sustained heart rate increase of at least 40 bpm is typically considered significant.
This heart rate increase should occur without a significant blood pressure drop, which differentiates POTS from orthostatic hypotension. Orthostatic hypotension is characterized by a sustained drop of 20 mmHg or more in systolic blood pressure or 10 mmHg in diastolic blood pressure within three minutes of standing. While transient initial blood pressure fluctuations can occur, a significant and sustained drop typically points towards orthostatic hypotension.
When to Seek Professional Medical Advice
Home tests like the “Poor Man’s Tilt Table Test” are valuable for preliminary assessment of your body’s responses to positional changes. However, these tests are not a substitute for a formal medical diagnosis. If your home test results suggest a pattern consistent with POTS, or if you experience persistent and disruptive symptoms, consulting a healthcare professional is the necessary next step.
A doctor can perform definitive diagnostic tests, including a formal tilt table test, in a controlled clinical setting. They can also rule out other medical conditions with similar symptoms. Avoid self-diagnosing or self-treating based on home test results, as professional medical guidance ensures accurate diagnosis and appropriate management.