A YORK heart specialist says he believes many Long Covid patients may actually have a condition called POTS - and could benefit from treatments used for patients with the syndrome.

Dr Sanjay Gupta, a consultant cardiologist at York Hospital, is an expert in POTS, or postural tachycardia syndrome.

The condition can leave sufferers debilitated, constantly exhausted, and sometimes unable even to walk.

The condition is thought to be caused by a malfunctioning of the autonomic nervous system which regulates the heart rate, blood pressure, digestion and sweating.

Symptoms can include palpitations, dizziness, brain fog, chest pain, gut problems, breathlessness and excessive sweating - similar to the symptoms reported by many Long Covid patients.

And like Long Covid, POTS often develops following a viral or other infection, Dr Gupta says. The symptoms can last for years, ruining patients’ lives. “Patients can feel that their lives are not worth living.”

One of the features of POTS, Dr Gupta says, is that the symptoms get worse when you stand up. When a healthy person stands, blood vessels narrow, and heart rate increases slightly to maintain blood supply to the heart and brain.

In POTS sufferers, this automatic adjustment to standing up doesn’t work properly, resulting in a greatly increased heart rate, and altered blood flow to the brain.

York Press: Dr Sanjay Gupta, a consultant cardiologist at York Hospital

Dr Sanjay Gupta

“So patients often try to avoid standing up, and spend a lot of time sitting or lying down,” Dr Gupta said. “A lot of patients use wheelchairs.”

Dr Gupta believes that, with POTS sufferers, an infection may have exposed an underlying ‘genetic vulnerability’.

This, in turn, causes a ‘disequilibrium’ in the autonomic nervous system, he says - with consequences which continue long after the initial infection clears up.

Dr Gupta set up a POTS clinic at York Hospital, which has now developed into a regional centre for POTS.

He uses a four-pronged approach to treating POTS. It involves:

  • medication to regulate blood pressure and heart rate
  • advice on lifestyle and diet, including increased intake of fluids and salt
  • physiotherapy, including the use of compression stockings
  • an advocacy service, which contacts employers or others on behalf of patients, to explain their condition.

“We look after almost 600 patients - many of whom were wheelchair bound and are now, with treatment, walking again,” he said.

Since the emergence of Long Covid, however, he has recognised that in many ways it is similar to POTS. In fact, he says, it may be the same condition.

“I suspect many patients with Long Covid may also get better with some of our treatments,” he said.

POTS is a recognised condition, Dr Gupta stresses. But because it is difficult to diagnose it is often not recognised by GPs. Sufferers can end up being marginalised or misdiagnosed.

Patients who suffer from POTS-like conditions should ask their GP for a referral to a specialist like him, he says. “They should be going to their GP and saying ‘I think I might have POTS'.”