History of POTS

Postural Orthostatic Tachycardia Syndrome is a type of dysautonomia. POTS has just recently begun to be recognized within the medical community. Patients with POTS commonly go undiagnosed for a year or more. Some doctors don’t recognize POTS as a genuine condition and claim it “isn’t real”; even more doctors simply do not understand. POTS just recently gained its name so it is just beginning to show up in television and pop culture.

Names

In 1993 researchers led by Dr. Philip Low at the Mayo Clinic coined the term “Postural Orthostatic Tachycardia Syndrome”. POTS was previously referred to as Postural Tachycardia Syndrome in 1982 by Philip Low and Ronald Schondorf at Mayo Clinic.

During the American Civil War Jacob Mendes Da Costa described a condition which may have been what we now call POTS. Da Costa called the condition “irritable heart”. Because Da Costa was the first one to describe the condition it is also described as Da Costa’s Syndrome. Da Costa’s syndrome is unique in that there are profound symptoms, but physiological abnormalities are usually absent. Because of this description many people assume Da Costa was describing a form of anxiety, but some of his patients may have actually had POTS.

Da Costa’s syndrome is also called cardiac neurosis, chronic asthenia, primary neurasthenia, effort syndrome[2][3], and neurocirculatory asthenia[4]. Da Costa described the symptoms of “irritable heart” to include palpitations, shortness of breath, chest pain, and fatigue upon exertion [5]. POTS is commonly misdiagnosed as an anxiety disorder. I think it is entirely possible that this “exertion sickness” was, at least in some cases, indeed POTS.

I have recently heard POTS called Astronaut Syndrome. When astronauts return to gravity from a lower-gravity state they may experience POTS-like symptoms. This term has not gained traction. I have also heard POTS called Grinch Syndrome because in some cases POTS is due to deconditioning and the heart is too small. Thankfully, this term has also not gained traction because it is simply inaccurate for most POTS patients.

Popular Culture

POTS doesn’t have a huge place in popular culture. It has been mentioned in House, MD. In the episode The Choice, POTS is suggested as a possible condition. However, in the end the patient does not have POTS but rather Chiari Malformation. Chiari malformation is seen in a number of POTS patients. In House, the orthostatic element of POTS (which not all patients have) is the focus of discussion.[6]

VSDucP0

POTS has also been addressed in Mystery Diagnosis. Marissa Irwin was featured in an episode of Mystery Diagnosis. She has POTS, Ehler’s Danlos, and Arnold Chiari Malformation. Patients have expressed frustration with how Mystery Diagnosis frames these cases. While POTS and EDS get exposure, the show likes to wrap the story into a pretty bow. This ignores the fact that these are chronic incurable conditions. Marissa is now a model and has been on the cover of Seventeen and Bridal Guide.
MarissaIrwin2

Some news stories have also featured or mentioned POTS. These stories are far from satisfactory in their understanding of POTS. For example, POTS is mentioned in 2010 by ABC News[7]. This terrible article claims that POTS is “curable”. This is simply false; some people grow out of POTS or cure an underlying condition, but there is no known cure.

In 2011, the American Heart Association did an article on POTS that was picked up by some news channels [8]. Frankly, this article grossly oversimplifies a complex syndrome. It claims that most POTS patients have a heart “two sizes too small” and call POTS “Grinch Syndrome”. A small subset of POTS patients have the condition due to deconditioning. Some others with POTS get worse because of deconditioning as a result of their POTS. In this case their heart may be smaller than normal. However, this is not the case in many POTS patients.

RRWM01R

In 2013, the Huffington Post wrote an article addressing America’s Next Top Model contestant Alexandra Agro. [9] Alexandra Agro states that she has POTS and was too sick to compete. Alexandra Agro also expresses unhappiness with Huffington Post not understanding her condition and made a video to raise awareness[10].

This is a running list. If you find another mention of POTS in pop culture please message me and I will add it.

  1.  “Neurasthenia”Rare Disease Database. National Organization for Rare Disorders, Inc. 2005. Retrieved2008-05-28.
  2. Paul Wood, MD, PhD (1941-05-24). “Da Costa’s Syndrome (or Effort Syndrome). Lecture I”Lectures to the Royal College of Physicians of LondonBritish Medical Journal. pp. 1(4194): 767–772. Retrieved 2008-05-28.
  3. Cohen ME, White PD (November 1, 1951). “Life situations, emotions, and neurocirculatory asthenia (anxiety neurosis, neurasthenia, effort syndrome)”.Psychosomatic Medicine 13 (6): 335–57. PMID 14892184. Retrieved 2008-05-28.
  4.  Paul O (1987). “Da Costa’s syndrome or neurocirculatory asthenia”.British Heart Journal 58 (4): 306–15.doi:10.1136/hrt.58.4.306.PMC 1277260.PMID 3314950.
  5. Selian, Neuhoff (1917). “XX”.Clinical Cardiology. New York: MacMillan. p. 255.; cited on “Da Costa’s Syndrome”. vlib.us. Retrieved 2007-12-18.
  6. http://en.wikipedia.org/wiki/The_Choice_%28House%29
  7. http://abcnews.go.com/Health/teen-finds-cure-mystery-illness-mayo-clinic-mother/story?id=11142991&page=2
  8. http://newsroom.heart.org/news/1356
  9. http://www.huffingtonpost.com/2013/10/07/americas-next-top-model-contestant-too-sick-elimination-video_n_4055887.html
  10. https://www.youtube.com/watch?v=l8kqxvOY7M8
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