Heart palpitations when standing suddenly, what is the cause?

Some people sometimes complain of a headache and dizziness after standing up suddenly. However, there are also those who feel their heart flutter when they stand up after getting up from sitting down. Is this normal? What caused it?

What causes heart palpitations when standing up suddenly?

A sudden palpitations when standing up is caused by a condition called postural orthostatic tachycardia syndrome (POT syndrome). This increase in heart rate is influenced by the earth's gravitational force when you change positions, for example from sitting for a long time or lying down to standing quickly. Other symptoms that may appear are lightheadedness and body shaking due to a sudden drop in blood pressure.

Normally, the blood will gradually flow down to the legs as soon as you get up slowly from sitting or lying down. But when you stand in a hurry, the earth's gravitational force pulls most of the bloodstream rushing towards your feet and pooling in the lower veins. Imagine the swift flow of a waterfall.

As an effort to compensate, the brain forces the heart to work extra hard to pump more blood so that it can be distributed to other parts of the body. Increasingly harder work of the heart will increase the heart rate, and at the same time, tighten the blood vessels and lower blood pressure. This mechanism actually aims to restore blood pressure to normal.

Other possible causes

Apart from sudden changes in posture, complaints of heart palpitations when standing suddenly may also be related to conditions:

• Pregnancy
• Too long lying down (bed rest)
• Just experienced physical trauma
• Has suffered serious injuries
• Heart disorders that cause changes in the function of the heart or blood vessels
• Nerve damage or impaired lower body nerve function
• Too long experiencing stress

Most cases of heart palpitations on standing occur only occasionally, especially when posture changes occur suddenly and quickly.

If you experience it very often, you should consult your doctor further. Some diseases can also cause symptoms of postural orthostatic tachycardia, such as:

• Autoimmune disease
• Diabetes and prediabetes
• Epstein-Barr virus infection
• Mononucleosis infection
• Hepatitis C infection
• Disease multiple-sclerosis
• Lyme disease
• Murmur syndrome
• Ehlers Danlos Syndrome
• Nutritional deficiencies, especially anemia

Signs and symptoms of postural orthostatic tachycardia

A person is said to have POT syndrome when their heart rate increases to 30-40 beats after 10 minutes of standing. Postural orthostatic tachycardia syndrome can also be diagnosed when the heart rate suddenly increases to 120 beats per minute after 10 minutes of standing.

In addition to palpitations when standing and sudden drop in blood pressure, postural orthostatic tachycardia also has other symptoms that can be mild to interfere with activity, including:

• Nausea and want to vomit
• Pain in the hands and feet
• Feeling dizzy, lightheaded, head spinning
• Fatigue suddenly
• Experiencing tremors
• The body feels weak, limp
• It's easy to feel anxious
• Difficulty breathing
• Chest pain
• Color changes in the hands and feet without cause
• Difficulty concentrating
• Cold sensation to the toes or feet
• Digestive problems (constipation or diarrhea)

Postural diagnosis of orthostatic tachycardia

If you often experience this condition, you should immediately consult a doctor. Your doctor can perform a physical examination of your symptoms to confirm the diagnosis.

The examination that the doctor may do is check the heart rate. Postural orthostatic tachycardia syndrome can be detected by looking at an increase in heart rate of up to 40 beats / minute for children aged 12-19 years, and an increase of up to 30 beats / minute for adults over 19 years. These symptoms and increased heart rate must have occurred for at least the last six months.

The doctor may also use tools such as tilt table test to monitor heart rate when the body changes posture and check heart rhythm with an electrocardiogram (ECG).

How do you deal with a pounding heart when you stand up suddenly?

Until now, there is no antidote to completely relieve the symptoms of postural orthostatic tachycardia syndrome. However, your doctor will likely give you drugs to help improve your blood flow, such as:

• Beta blockers.
• SSRI.
• Flurdrocortisone.
• Midodrine.
• Benzodiazepines.

Some other things you can try to relieve symptoms of postural orthostatic tachycardia are:

• Maintain body fluid balance by drinking lots of water and limiting salt intake.
• Avoid drinking a lot of caffeine or alcohol.
• Routine physical activity. Just light physical activity such as regular walking can increase blood flow and maintain a healthy heart.
• If you tire easily, choose sports that can be done in a sitting position, such as yoga or using a stationary bike.
• Maintain blood pressure within normal limits
• Schedule sleep on time.
• Use a headwear that is higher than the surface of the body when sleeping.

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