In a cross-sectional study, researchers found that certain patients with postural tachycardia syndrome (POTS) symptoms might be feeling panic due to past fainting incidents.

Researchers evaluated 28 patients with postural tachycardia syndrome (31 12 years old, 25 women) and 21 matched controls, and studied the effect of fear conditioning and its relationship with tachycardia and cerebral hypoperfusion upon standing. When adult POTS patients and healthy controls were compared, it was discovered that POTS patients had higher levels of somatic vigilance and anxiety, more pronounced anticipatory tachycardia just before assuming the upright position in a tilt-table test, a faster heart rate, hypocapnia, cerebral hypoperfusion, and the release of epinephrine into the bloodstream.

These results imply that postural tachycardia syndrome is a functional psychogenic illness in which just rising-up can take on a terrifying aspect and trigger a conditioned scared reaction even when experienced alone. A fear-conditioned hyperadrenergic state when standing is connected with and may be predisposed to increase bodily anxiety. There are therapeutic implications to these findings and the results were published in the Brain.

(Medscape - Jul 20, 2022)Brain, awac249, https://doi.org/10.1093/brain/awac249