If you get dizzy and lightheaded when you stand up, you may have a condition called postural orthostatic tachycardia. Research shows that as many as 3 million Americans may have this condition, which is also known as POTS. What's even more alarming is that the average time it takes for someone to get properly diagnosed with POTS is 5 years and 11 months.
That's almost 6 years of not knowing that there is something seriously wrong with your health. One very important thing to understand about this medical condition is that it can be dangerous when getting dental treatment. Here's what you need to know about POTS and why your dentist wants to know if you have it.
Postural Orthostatic Tachycardia
When someone has this condition and they stand up from a supine position (lying down while facing upward), their blood pressure drops and all the blood pools to their lower extremities. This causes their heart to race as it tries to pump the blood back up to the heart and brain. With a reduction of blood in the brain, they may black out or pass out altogether. They may also get nauseous, feel anxious, and have blurred vision.
With these types of symptoms, it's difficult to understand why it can take so long for a proper diagnosis. However, there are many other co-morbid or related conditions that can cover the symptoms of POTS, such as fibromyalgia, chronic fatigue syndrome, and lupus. If you feel that you may have POTS, ask your physician to schedule you for a tilt table test, which safely tests your blood pressure in various positions.
Mitral Valve Prolapse
Many people with POTS also have, or will develop at some point, a mitral valve prolapsed in their heart due to the way the blood pools in the extremities upon standing. This is when the valve in between the two heart chambers does not work properly, which can cause bacteria to get trapped. This, in turn, can lead to endocarditis, which is an infection in the lining of the heart.
One way that bacteria gets into the blood is when dental work is done. The reason for this is because there is always bacteria in your mouth and the bacteria can easily get into your bloodstream through any open wound, including surgical openings or tears in the gum tissue that can happen during routine dental treatment.
Anyone who has been diagnosed with POTS should see their physician prior to dental work so he or she can check to see if they have developed a mitral valve prolapse before getting dental work, including emergency dental treatment. If found, the patient will need to start on an antibiotic regimen before getting dental treatment.
Anesthesia & Epinephrine
People who have POTS should not go under general anesthesia. This is one of the reasons why your dentist asks questions regarding medical history before any dental treatment is done. When someone with POTS is given general anesthesia it can cause them to go into cardiac arrest. It's the epinephrine in the anesthesia mix that causes problems. Fortunately, your dentist can use a local anesthetic that does not contain epinephrine.
Another crucial thing to realize is that your body naturally makes epinephrine, especially as an automatic response to things like pain, anxiety, and fear. Therefore, your dentist will need to use enough anesthesia so that your body doesn't start producing epinephrine as a result from experiencing too much pain and/or having too much anxiety.
After the dental treatment has been done and the anesthesia has worn off, your chair should be elevated slowly by the dentist or his or her dental assistant so your blood pressure doesn't drop as you come up from lying down. That way, your body will ease into an upright position so you won't pass out or black out from POTS.