Acute Water Ingestion as a Treatment for Postural Orthostatic Tachycardia Syndrome

Abstract

A 24-year-old female presented to our clinic with symptomatic tachycardia. In the clinic, she was able to replicate her symptoms, which were due to tachycardia in a standing position that resolved upon sitting. The patient was then offered eight ounces (236.6 mL) of water and, after consumption of such, the standing tachycardia was no longer observed. A diagnosis of postural orthostatic tachycardia syndrome (POTS) was made. This case report discusses a novel approach to acute treatment for POTS.

Hemodynamic Effects of the Osmopressor Response: A Systematic Review and Meta‐Analysis

“…While out of the scope of this meta‐analysis, these findings would likely be different if studies were conducted in the standing position. In one case report, Ziffra and Olshansky 14 reported on a patient with POTS whose HR initially doubled upon standing, which then resolved after drinking 236.6 mL of water. Similarly, in the Shannon et al paper, the osmopressor response induced a decrease in HR from 123±23 bpm to 108±23 bpm in 9 patients with POTS while standing.…”

“… 12 A case report also demonstrated that rapid consumption of 8 oz (236.6 mL) of water in a patient with postural tachycardia syndrome (POTS) eliminated standing tachycardia within 10 minutes. 14 Finally, a study of healthy individuals suggested that water consumption may be a simple and effective way to prevent vasovagal reactions, especially in situations such as blood donation, where vasovagal reactions occur more frequently. 15 The investigators found that of 22 healthy adult participants, 8 experienced hypotension or bradycardia within the first 30 minutes of HUT when they did not consume water beforehand.…”