Exercise May Help Treat POTS Heart Condition

June 20, 2011 -- An exercise training program worked better than medication for those with a debilitating heart problem that's dubbed the "Grinch syndrome," new research suggests.

The condition is so named because those who suffer from it have a heart that's too small.

The medical term for the condition is POTS, short for postural orthostatic tachycardia syndrome. About 500,000 in the U.S., mostly young women, are affected. 

Among other symptoms, those with POTS have a rapid increase in their heartbeat when they change from lying down to standing. The volume of blood pumped out from the heart with each beat is low. That can make it difficult to stand for long periods. Quality of life can suffer greatly.

''We have come to the conclusion that the essence of the condition is a small, atrophied, deconditioned heart," says study researcher Benjamin D. Levine, MD, director of the Institute for Exercise and Environmental  Medicine at Texas Health Presbyterian Hospital and professor of medicine at the University of Texas Southwestern Medical Center, Dallas.

In the new research, he says, "the heart was too small, we made it bigger [through exercise] and the symptoms went away."

The team found the same benefits to exercise in a previous study. However, in the new study, they found that exercise training made patients feel better without using the beta-blocker medication commonly given to lower the heart rate.

The study results are potentially good news for people like Amy Krakower, 26, a San Diego law school graduate diagnosed at age 23 with the condition. She was so affected, she tells WebMD, that "I couldn't walk up the stairs to my contracts class without feeling like a 90-year-old woman."

In his small study, Levine found that a rigorous exercise program, which began with participants exercising on recumbent equipment, helped many and cured 10 of 19 patients.

The study is published in Hypertension: Journal of the American Heart Association.

Exercise Program for Grinch Syndrome

Levine and his team evaluated 19 people with POTS (including one man) and compared them to 15 people without the condition (including one man).

Before the exercise part of the study, the patients were randomly assigned to take a beta-blocker drug, propranolol, or a placebo. The beta-blocker is given to reduce the rapid heartbeat.

But Levine's team wanted to find out if reconditioning the patients with the exercise would improve the condition and make the medications unnecessary.

After the medication phase, the researchers found that those on the beta-blockers had no changes in social function scores. Very few had improved physical function scores.

At the beginning of the three-month exercise program, patients worked out on recumbent equipment such as rowers or bikes or they swam. "We started with about three or four times a week, about 25 to 35 minutes including warm-up and cool-down," says study researcher Qi Fu, MD, PHD. She is an assistant professor of medicine at the University of Texas Southwestern Medical Center and a researcher at the Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital.