Many physicians mistake the physical symptoms of POTS, such as tachycardia, palpitations, and shortness of breath, as the signs of an anxiety disorder or some other psychological problem.  Prior research has documented that POTS is not associated with increased levels of anxiety or psychiatric disorders, that POTS symptoms are phenomenologically different and clinically distinguishable from panic disorder, and that the upright tachycardia seen POTS patients is not caused by anxiety.

Despite publication of this research, many physicians continue to misdiagnose POTS patients as having anxiety disorders or other psychiatric conditions.   While psychiatric disorders are serious health problems that require proper treatment, the treatment for these conditions is not the same as the treatment for POTS, and can sometimes make POTS symptoms worse.

New research provides additional proof that POTS is not “all in your head.”  A study recently published in Clinical Autonomic Research, Visceral sensitization in postural tachycardia syndrome, examined whether palpitations frequently reported by POTS patients were psychological or organic in origin.  Palpitations are those thumping, fluttering, pounding sensations everyone feels from time to time in their heart, but many POTS patients experienced palpitations on a regular basis, and much more so than healthy individuals.

This study found that POTS patients “did not amplify their somatic and visceral sensations compared with control subjects, indicating that they are not predisposed to exaggerating every symptom and militating against psychologic origin.”  After analyzing the data collected, the study’s author, Dr. Ramesh Khurana, concludes that the palpitations in POTS “are of an organic origin.”

However, Dr. Khurana notes that POTS patients had greater ability to discriminate the type of palpitation compared with healthy subjects, “favoring visceral hypersensitivity and a central origin of POTS symptoms.”  Visceral sensitivity is a medical term used to describe an increased sensation of pain and sensations coming from your own internal organs, more so than a normal person would experience.  By “a central origin” Dr. Khurana is referring to the central nervous system, which includes the brain and spinal cord.  He explains, “potential locations for visceral hypersensitivity include sensory receptors in the cardiovascular system, extrinsic sensory afferent neurons, spinal nociceptive neurons, medulla, midbrain raphe, hypothalamus, and cortex.”

Dr. Khurana also reminds us that POTS is heterogeneuous condition, and that the concept of visceral sensitization may not apply to every POTS patient.  He notes that palpitations did not occur in all of the POTS patients who participated in the study.

Dysautonomia International is actively raising funds to support additional research on POTS.  If you would like to support POTS research, please visit our donation page today.

by

by