Let's talk about Postural Orthostatic Tachycardia Syndrome (POTS)! 🗒️
POTS is a disorder of the autonomic nervous system, which is the branch of the peripheral nervous system that controls your bodily functions, organs, and all the stuff inside you that you don't consciously operate. One of these functions is blood pressure regulation, where your body is making hundreds of microadjustments to make sure that your heart and vessels are getting adequate blood flow and perfusion out to your body. Not only that, but the blood also needs to be able to return to the heart, so it can be re-oxygenated and pumped out again. Moving all of that blood forward requires coordination of the musculature to compress and push that blood up through the veins: when you're lying down, there's not much force to overcome, but once you suddenly stand up? Now your body needs to fight against gravity in order to make sure all that blood gets back up through the system! In POTS, sometimes the nervous system isn't able to signal the body and muscles to compensate for this change, and so alternatively the heart rate needs to be jacked up in order to maintain the appropriate cardiac output. The excessive sympathetic activation and compensatory tachycardia is what gives many people the classical symptoms of palpitations, dizziness, and fatigue in POTS.
Officially, the diagnosis is made with a heart rate increase of >30 bpm within 10 minutes of standing up or on a tilt-table test (without a drop in blood pressure - that's orthostatic hypotension and something else). The pathophysiology is multifactorial, generally involving a dysautonomia, vascular dysfunction, or in hypovolemic, hyperadrenergic, and deconditioned states. It's very common to see in patients with Ehlers-Danlos syndrome, MCAS, and studies suggest increasing prevalence in an autoimmune population as well. It's a clinical diagnosis based on the history and physical exam, with the confirmatory test done on tilt table. It's also important to exclude mimics and rule out other causes of tachycardia such as anemia, hyperthyroidism, or medication side effects.
Management usually beings with non-pharmacologic intervention, including patient education, exercise and physical countermaneuvers, and increased fluid and salt intake. There are no medications that can truly "solve" POTS, with limited current evidence for pharmacologic intervention outside of targeted symptom management for refractory cases. These include, but are not limited to, low-dose beta-blockers for tachycardia, midodrine for hypotension, fludrocortisone for mineralocorticoid effect, and pyridostigmine for nervous system signalling augmentation. One of the best therapies for POTS out there are compression garments: Compression stockings especially are highly effective at physically compressing the venous system in the lower limbs, which facilitates blood flow and venous return. Current recommendations recommend daily wear, removal at bedtime, and replacement every 3-6 months.
THANK YOU SO MUCH FOR BEING SO SUPPORTIVE AND HELPING ME GET MY FIRST EVER SUIT!! 🥹 my childhood dream came true!!
as promised i took pics to show u! i dont have a tie yet, i’ll buy one soon💀
(now watch me be too pussy to ever use this outside)
i can imagine how heartbroken his parents were. my mom was so heartbroken when i told her my dad's wife would hit me, verbally and psychologically abuse me. there was nothing she could've done to change things, but mom still feels guilty. no kid deserves to go through this pain.
bang chan used to not tell his parents ha ha ha when he got hit and scolded by the company ha ha ha when he was baby ha ha ha but he told them recently, and they were in tears ha ha ha ha....
Me sorprende (para nada) como el gobierno solo piensa en quitar plata de otros sectores para que adultos mayores avancen rápido en listas de espera, pero no buscan soluciones para que no hayan listas de espera en general o reducirlas para TODOS. Siempre con el camino corto.
"somos un país en envejecimiento", "baja natalidad", ¿y así esperan que esto cambie? solo enfocándose en 1 sector etario, quitando financiamiento a la educación, haciendo lo posible para que el país se deteriore y empeore, mientras llenan los bolsillos denquienes no lo necesitan.
pasen a leer la minuta de las mentiras que quiere instalar el gobierno
se puede ser más frívolo ??
pensando en instalar un relato, mientras ponen una bomba en el presupuesto de las familias de clase media, solo les interesan los réditos políticos, se les cayó la máscara
RENUNCIA @crvalenzuela !!
Este video es dinamita pura y refleja la contradicción eterna que tiene Kast.
Estuvo 20 años en la cómoda posición del criticador, De tirar papeles con caca con ventilador pasó a indignarse porque lo critican.
Otra cosa es con guitarra.
Dale Retweet
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