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POTS and driving

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Hi everyone! I recently started driving and yesterday I got my first heart palpitations episode while at the wheel (feels like my heart is shaking; lasts anywhere from 10 seconds to 30 minutes, sudden onset without need of trigger). It only lasted a few seconds and nothing went wrong (I just kept driving straight), but I'm worried it could happen again for longer and/or when I need my full attention. While the episodes are pretty infrequent (one every 3-6 months), there's often no warning. On off days, the stress of driving can be enough to make me feel ill (tachy, short of breath) while driving (those days, I just don't drive).

When I got my license, I told them I have POTS and explained what it is, and they still gave me a license. Do you think I should talk to my doctor about my fitness to drive? Also, had anyone had similar issues with palpitations? If so, do you drive, and do you have any issues driving? Thank you!

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I drive ~30,000-50,000 miles (50,000km-80,000km) a year, mostly for work.

I look at it this way:  Let's assume I'm fully healthy.  There will still be times I'm not fit to drive, such as having the flu or being drunk.  Everyone at some point has been sick, many have been drunk.  Does that mean they should hand in their licenses? No, then practically no one would have a license.  I know a few commercial airline pilots and every single one of them likes to drink and has the stories to prove it.  BUT they're not afraid to call in if they're not feeling up to duty.  

So, I drive and keep an eye on myself.  If I'm not feeling well, I don't drive.  If I start to feel weak while driving, I pull over.   When I bought my most recent car, I kept my medical issues in mind, so I upgraded the sound insulation & glass to reduce fatigue caused by noise, upgraded the driver's seat for better adjustability, and semi-autonomous driving systems.  The upgrades weren't cheap, but it makes a world of difference.   When I can drive for 2-3 hours and feel refreshed vs. looking for the nearest flat surface to nap on or having to pull over mid-trip, I'd say it works!

Re: driver's license... my own doctor said you never want to get into a pi**ing match with the DMV over your health. Say as little as possible to the DMV and keep the license.  If you're not fit to drive, don't drive.  If you don't trust yourself, give the license over to a friend.  Some states are worse than others when it comes to reinstating licenses.  

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Have you had a heart workup from your cardio - ECG, EKG, stress test, etc?  This should generally pick up anything that is wrong with your heart that would cause you to faint, etc.  Palpitations are pretty common and they are scary, but they are usually not dangerous for POTS patients.  I would get the workup as a starting point, which you should be able to do without mentioning your concern about driving.


Edited by yogini
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I've had multiple EKGs but they never caught anything (no episodes) and wore a monitor for two weeks but had no episodes during that time. So I'm not sure what is physically happening to my heart during the attacks. It's against been over a year since visiting my cardiologist so I would have to go back through the referral system to see her. I'll talk to my (mostly unhelpful) GP about getting a referral.

And the worry with the palpitations is not that they're dangerous, but that they happen suddenly without warning and I cannot focus during an attack.

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