If your heart seems to race or pound whenever you stand up, you're not alone. This symptom — called postural tachycardia — is one of the hallmark signs of POTS (Postural Orthostatic Tachycardia Syndrome).
What's Happening When Your Heart Races on Standing?
When you stand up, gravity pulls blood toward your legs. Normally, your body compensates by:
- Constricting blood vessels
- Slightly increasing heart rate (10-20 bpm is normal)
- Maintaining blood pressure and brain perfusion
In people with POTS, this compensation doesn't work properly. Instead of a modest increase, the heart rate can jump by 30, 40, or even 50+ beats per minute upon standing. This is the "tachycardia" in Postural Orthostatic Tachycardia Syndrome.
Is It Normal for Heart Rate to Increase When Standing?
Yes, some increase is normal. Here's how to tell the difference:
Normal Response
- Heart rate increases 10-20 bpm
- Settles within 1-2 minutes
- No significant symptoms
POTS-Like Response
- Heart rate increases 30+ bpm (adults) or 40+ bpm (teens)
- Stays elevated while standing
- Accompanied by symptoms
Other Symptoms Often Experienced Together
People with postural tachycardia often experience these alongside racing heart:
- Dizziness or lightheadedness
- Palpitations (awareness of heartbeat)
- Chest discomfort
- Shortness of breath
- Brain fog
- Fatigue
- Feeling like you might faint
Other Causes of Racing Heart on Standing
While POTS is one cause, other factors can contribute:
- Dehydration
- Anemia
- Thyroid problems
- Medication side effects
- Caffeine or stimulants
- Anxiety
- Heart conditions
This is why proper evaluation by a healthcare provider is important.
How to Track Your Heart Rate Response
POTS Check measures exactly how much your heart rate increases when you stand up, giving you objective data rather than just describing "my heart races."
What POTS Check Shows You
- Your resting (baseline) heart rate
- Your maximum standing heart rate
- The exact change (ΔHR) in beats per minute
- Whether your increase meets POTS criteria
- A PDF report to share with your doctor
When to Seek Immediate Care
Seek emergency medical attention if racing heart is accompanied by: chest pain, severe shortness of breath, fainting, confusion, or if your heart rate feels irregular or erratic. These could indicate a more serious condition.