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Blood Flow & Pots


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Hi everyone. I haven't been posting for the past few months. I've been having considerably more trouble this past three months and was going through different doctors. Anyways, long story short. I've been pondering on a question... does anyone know what's the relationship between blood flow to the heart and POTS? By that I mean, I've been having chest pain episodes. While my doctor thinks it's POTS related, I can't help but wonder there's something wrong in my blood regulation with my heart. I know chest pains can be chest wall related, or POTS related and I tend to get different kinds of sensation when I say "chest pain." (There are ones that I don't care about anymore) I just want to know---should I keep pushing my doctor on the blood regulation type chest pain? Or is that just POTS related and I should just ignore it?!

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It's always good to have your doctor check you for any underlying heart problem, especially if you're noticing an increase in your chest pain. However, my cardiologist says that most POTS-related chest pain results from thoracic hypovolemia. I do know that, for me, lying down helps my chest pain in most cases which would make sense with the thoracic hypovolemia theory.

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My understanding is that when we get chest pain that seems to be cardiac (ie feels like a heart attack would feel) it is caused by too little blood flow getting down our coronary arteries. Unlike ischaemic heart disease it isn't caused by narrowings / blockages in the coronary arteries but by problems with blood flow in the area.

It is interesting to note that the coronary arteries receive their blood directly from the aorta but that blood flows down the coronary arteries during diastole (the gap between heart beats). When you have a fast tachycardia diastole gets shorter (ie there is less time between heart beats). This means that there is less time for the blood to flow down the coronary arteries. This would fit alongside and compound the thoracic hypovolaemia research. If there is less blood and less time for blood flow then the poor coronary arteries will struggle to get all the blood they desire.

Importantly POTS related chest pain should improve with rest and lying flat. Anyone getting new chest pain or different pain should always get checked out by a doctor but once you have been told it is POTS related and not ischaemic heart disease then you can treat the pain with rest and lying flat rather than having to visit the ER every time.


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