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Orthostatic hypotension & POTS

Hypotensio orthostatica · Ortostatická hypotenze a POTS

What it is

Blood pressure or heart rate misbehaves on standing.

Symptoms & signs

  • Dizziness on standing
  • fainting
  • brain fog
  • palpitations
  • fatigue
  • worse in heat

🚩 Get help if…

  • call 112 / 911 now Fainting with chest pain, palpitations or breathlessness
  • call 112 / 911 now Fainting during exercise or lying down
  • see a doctor soon Falls or injuries from dizziness on standing
  • see a doctor soon Dizziness after starting or changing a medicine

Where it strikes

Medical treatment

  • Fludrocortisone
  • midodrine
  • ivabradine for POTS
  • compression garments
  • review blood-pressure drugs

Natural & lifestyle

  • 2–3 L fluid and 8–10 g salt daily
  • compression stockings to the waist
  • recumbent exercise progression
  • small frequent meals

Emerging & experimental

  • Autoantibody-targeted therapy
  • IVIG in autoimmune POTS

Alternative, off-label & anecdotal

Approaches used outside the guidelines, with what their supporters report and what testing has found so far.

  • Low-dose naltrexone and pyridostigmine in POTS — small studies early / small studies
  • Electrolyte drinks and liquorice — widely used; liquorice raises pressure but also lowers potassium anecdotal / traditional
  • Transcutaneous vagus nerve stimulation — small trials early / small studies

ICD codes