Feeling your heartbeat in your head when standing up, often a whooshing or thumping sound synced with your pulse, is usually pulsatile tinnitus, caused by turbulent blood flow or pressure changes, and can be linked to issues like anemia, high blood pressure, thyroid problems, or even Postural Orthostatic Tachycardia Syndrome (POTS) where your heart rate speeds up too much upon standing. While sometimes harmless (like a venous hum), it can signal underlying vascular or pressure issues, so seeing a doctor for diagnosis is important to rule out serious causes like narrowed arteries or intracranial hypertension.
Feeling a pulse through the temporal artery can signal a malformation in the blood vessel, though this is rare. It can also happen when your heart is moving extra blood with each heartbeat, which can occur with common problems like thyroid disease or anemia.
Common Signs of POTS
Racing heart and light-headedness when going from lying down to standing. Reddish-purple color in feet or legs. Heart palpitations, or feeling your heart pounding or racing. Shortness of breath.
Postural tachycardia syndrome (PoTS) is when your heart rate increases very quickly after getting up from sitting or lying down, often making you feel dizzy or lightheaded. There's currently no cure, but it can be managed with changes to your lifestyle, or sometimes treatment with medicines.
Three early warning signs of heart failure include persistent fatigue/weakness, shortness of breath (especially with activity or lying down), and swelling (edema) in your legs, ankles, and feet, often accompanied by rapid weight gain from fluid buildup, all signaling your heart isn't pumping efficiently enough. Other key indicators are a chronic cough (sometimes with pink mucus) and heart palpitations.
POTS is diagnosed using either a 10-minute standing test or a head-up tilt table test; occasionally other tests are performed to identify specific characteristics of POTS present in some patients. Most people's POTS symptoms respond to a combination of diet, medications, physical therapy and other treatments.
POTS (Postural Orthostatic Tachycardia Syndrome) most commonly begins in teenagers and young adults, especially females, often between ages 15 and 25, with many cases starting around puberty or following triggers like viral infections, pregnancy, trauma, or surgery. While it can affect any age, early adolescence (around 12-15) is a peak time for symptom onset, with a significant portion starting after a specific stressful event, say National Institute of Neurological Disorders and Stroke and National Institutes of Health (NIH) | (.gov).
Common differential diagnoses for POTS include thyroid disorders and thyrotoxicosis, inappropriate sinus tachycardia, pheochromocytoma, anxiety, dehydration, infection, hypoadrenalism, and medication-induced tachycardia.
Stand up with your heels 6-8 inches from the wall, keeping your shoulders against the wall. Measure your heart rate and blood pressure at 1-minute intervals for 10 minutes. Symptoms like dizziness, palpitations, or lightheadedness during the test may indicate orthostatic intolerance or POTS.
Pulsating headaches are often associated with migraines, but they can also indicate other health issues, some of which can be very serious (such as high blood pressure affecting blood vessels in the brain).
A high blood pressure headache often feels like a pulsating or pounding pain, and these pains may worsen with activity or sudden movement. Studies have shown that high blood pressure may cause headaches. Therefore, it is essential to monitor your blood pressure.
POTS (Postural Orthostatic Tachycardia Syndrome) triggers often involve significant physiological stressors like viral infections (e.g., COVID-19), surgery, or head injury, alongside common factors such as dehydration, heat, hormonal shifts (periods, pregnancy, menopause), and prolonged standing; while these can initiate symptoms, triggers like large meals, strenuous exercise, and certain medications can worsen existing POTS.
Symptoms of low blood pressure
Look for clues pointing to diseases that can produce a POTS-like phenotype, such as:
A POTS (Postural Orthostatic Tachycardia Syndrome) self-test, often called the "Poor Man's Tilt Table Test," involves lying down for 5 minutes, measuring your heart rate (HR) and blood pressure (BP), then standing still for 10 minutes while repeatedly checking HR and BP, looking for a significant HR increase (≥30 bpm adults, ≥40 bpm kids/teens) without a major BP drop, alongside symptoms like dizziness. This screening helps gather info for a doctor, but it's not a diagnosis; you still need professional confirmation.
POTS (Postural Orthostatic Tachycardia Syndrome) is usually diagnosed in teenagers and young adults, most commonly affecting females between the ages of 15 and 50, with symptom onset often occurring after puberty, viral illnesses, surgery, or pregnancy, and frequently presents between 15-25 years old. While it can affect any age, the peak age range for diagnosis is in the late teens and early twenties, often triggered by common life events.
The classic symptom of POTS is a fast heartbeat. A person's heart rate may increase by more than 30 beats per minute or exceed 120 beats per minute within 10 minutes of standing. The rapid heartbeat usually improves when the person lies down again.
If you've been diagnosed with POTS, don't worry—it is not life-threatening and does not affect your life expectancy. However, certain things can make your POTS symptoms worse. It's important to know your triggers so that you can avoid or modify situations to avoid worsening unpleasant symptoms.
An increased heart rate due to exercise, stress, fear, medications, or fever can be completely normal and is called sinus tachycardia. If your heart is beating fast for no reason, it is called inappropriate sinus tachycardia.
If they suspect you have PoTS, they may do further tests, like: blood tests. urine test. heart and blood pressure tests, like an echocardiogram, an ECG, and 24-hour blood pressure and heart rate monitoring.
POTS can be considered a disability if its symptoms are severe enough, however. Generally, this requires that your symptoms prevent you from working or performing daily activities. To receive disability benefits for POTS, you will need to be tested for the condition and medically diagnosed.
Yes, Postural Orthostatic Tachycardia Syndrome (POTS) can come on suddenly, often triggered by events like viral illnesses (including COVID-19), physical trauma (like concussions or surgery), major stress, pregnancy, or significant hormonal changes, though sometimes there's no clear trigger. Symptoms can also develop gradually, but a rapid onset after an infection or injury is a common pattern for many people.
High cholesterol often has no symptoms, but when it causes problems, warning signs include chest pain, shortness of breath, numbness or coldness in limbs, unexplained fatigue, dizziness, headaches, leg pain/cramps, yellowish skin deposits (xanthomas), a grey ring around the iris (corneal arcus), and slow-healing sores/ulcers on feet, indicating poor circulation. These signs often point to related conditions like Peripheral Artery Disease (PAD) or heart issues from plaque buildup, but the only sure way to know is a blood test.
Main symptoms
fatigue – you may feel tired most of the time and find exercise exhausting. swollen ankles and legs – this is caused by a build-up of fluid (oedema); it may be better in the morning and get worse later in the day. feeling lightheaded and fainting.