Postural tachycardia syndrome (POTS), a disorder that causes lightheadedness, fainting, and a rapid heart rate, is common among patients with migraine, according to information presented at the Eighth Annual Winter Conference of the Headache Cooperative of the Pacific, which was held in January.

Nearly 30% of people with POTS have migraine, according to Brent Goodman, MD, of the Mayo Clinic in Scottsdale, Arizona, who conducted a retrospective study to investigate the link. Additionally, Dr. Goodman and his colleagues found that 46% of migraine patients experienced syncope—a loss of consciousness because of a drop in blood pressure—at least once and were more likely to experience recurrent syncopal episodes than people without migraine. These and other findings suggest that migraine may be predisposed to having symptoms of orthostatic intolerance—problems that appear when standing up but disappear when sitting or lying down.

Dr. Goodman noted that POTS is the most common autonomic disorder that he sees. If patients experience headache, cognitive difficulty, postural lightheadedness, syncope, and postural tachycardia, they may, in fact, have POTS. Gastrointestinal symptoms such as constipation, diarrhea, and frequent urination may also be present.

Diagnosis of POTS can be challenging and is frequently missed, but help is possible for those who have it, although there is no cure.

NHF President Arthur Elkind, MD, suggests that headache patients who have symptoms of POTS should seek specialized professional medical advice. It is recommended that migraineurs seek care from a neurologist who is a headache specialist, and if individuals believe they have episodes of orthostatic hypotension, cardiac consultation may be in order. POTS is only one disorder that causes a fall in blood pressure with symptoms resulting in falls and syncope, and careful medical evaluation is suggested.