Understanding the Nature and Impact of Chest Pain in Postural Orthostatic Tachycardia Syndrome

<h2>Abstract</h2><h3>Background</h3> Postural Orthostatic Tachycardia Syndrome (POTS) is a chronic autonomic disorder that predominantly affects female patients of childbearing age. Chest pain is a common and debilitating symptom in POTS, but the nature of the chest pain and the patient experience surrounding it remain poorly understood. <h3>Methods</h3> A qualitative descriptive design was used. Sixteen patients diagnosed with POTS who were experiencing chest pain were recruited. Semi-structured video interviews were conducted that explored the nature and impact of chest pain on daily life. Transcribed interviews were manually analyzed using conventional content analysis. <h3>Results</h3> Most patients described their chest pain as sharp and stabbing with pain often radiating from the left side of the chest to the jaw, back, or arms. Triggers for chest pain included physical exertion like walking and stairs and high temperatures, though few described the pain as unpredictable. Frequency and duration varied widely across patients, with episodes ranging from fleeting to constant episodes. Many shared that chest pain restricted physical activities that they once engaged in with their peers and had social lives directly affected as shortness of breath from talking could trigger chest pain. Many patients also described feelings of isolation and frustration because of limited social and physical activities, as well as their recognition of a decrease in their overall capabilities. The most common coping strategies to mitigate chest pain was sitting or lying down and breathing strategies. <h3>Conclusions</h3> Chest pain in POTS affects multiple dimensions of patients' lives and requires ongoing adaptation and coping.