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Have Lupus And Dysautonomia. Woke Up With Shortness Of Breath. Started Birth Control Pills. Could This Be POTS?

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Posted on Mon, 23 Sep 2013
Question: I am 27 with lupus and dysautonomia (POTS syndrome)- both are very mild and I can deal usually very easily - I also just had my lupus blood work (CBC, BMP, Inflammation markers drawn 2 weeks ago) and all was well.
I woke up this morning felt short of breath- I can walk do things , eat, no problem but feel "breathless" and the need to breath deeper.

I JUST started due to the shortness of breath so i stopped

the breathlessness continued all day today easing up at some point and coming back.
I get some shooting pains in my back too but that happens on occasion
I am not coughing, not coughing up blood, no chest pain, no dizziness , just shortness of breath

could this be from my POTS that I have?
I am scared it could be a PE due to being on Birth control for a few days.....

I had this before 3-4 months back and it lasted 2 weeks - I went to the ER pulse ox was ok, CT chest was fine, Echo was fine.

getting nervous here.....
doctor
Answered by Dr. Nsah Bernard (1 hour later)
Brief Answer:
In your case, POTS could be the culprit

Detailed Answer:
Hello,

Thanks for posting,

I started by saying your case the most likely cause could be POTS because in most cases of shortness of breath or dyspnea the culprit will unlikely be POTS as first suspected cause. But since, you are already a known POTS patient, it is likely going to be the cause but how ever, it will be wise to consider the fact that you might suffering from anxiety attack.
I personally do not think that birth control you started is directly responsible but other common causes of shortness of breath should be investigated before we can conclude that POTS might be responsible. POTS does not usually present with a single symptom that is why they define it as a syndrome. You should expect:
Headache, fatigue, sleep disorder, weakness, hyperventilation/dyspnoea, tremulousness, sweating, anxiety/palpitation, dizziness/vertigo, pre‐syncope/syncope etc. At least 3-5 of the above symptoms should be present together with signs that can only be identified by a doctor or health care provider while examining you.
It will be wise at this point to stop your current medication especially the nadolol (which is a beta blocker that precipitates and aggravates POTS).
I believe that you seeing a doctor at this stage is paramount and you should try getting an appointment ASAP.

Hope this helps and if you have any further questions, do not hesitate to write back.
Dr. Nsah
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Nsah Bernard (27 minutes later)
oh def have all those symptoms, presycope, anxiety, sweating, tremors, heart rate is rapid upon standing. the shortness of breath ive only had a few times. the doctor put me on nadolol due to the high heart rate. but maybe i should be on something else. I was diagnosed with POTS through a tilt table and a lot of ruling out . I was just scared of the new shortness of breath- I did have it 3 months ago but it went away
anything i can do to help it
doctor
Answered by Dr. Nsah Bernard (14 minutes later)
Brief Answer:
Rest and lie at a 45 degree angle.

Detailed Answer:
Hello,

Thanks for follow-up,

All you can do for shortness of breath is take some rest, then place pillow at a 45 degree angle so your lungs lie diagonal to gravitational field strength. This should help you breath more at ease. I believe nadolol is contraindicated in POTS, so that should be taken off. Other medications are available for fast heart rate ( I allow that to your doctor's discretion to prescribe).
I suggest you call your doctor for opinion on how to handle your current situation.
Anxiolytics can also help.

Hope this helps further.
Dr. Nsah
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
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Dr. Nsah Bernard

General & Family Physician

Practicing since :2012

Answered : 1704 Questions

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Have Lupus And Dysautonomia. Woke Up With Shortness Of Breath. Started Birth Control Pills. Could This Be POTS?

Brief Answer:
In your case, POTS could be the culprit

Detailed Answer:
Hello,

Thanks for posting,

I started by saying your case the most likely cause could be POTS because in most cases of shortness of breath or dyspnea the culprit will unlikely be POTS as first suspected cause. But since, you are already a known POTS patient, it is likely going to be the cause but how ever, it will be wise to consider the fact that you might suffering from anxiety attack.
I personally do not think that birth control you started is directly responsible but other common causes of shortness of breath should be investigated before we can conclude that POTS might be responsible. POTS does not usually present with a single symptom that is why they define it as a syndrome. You should expect:
Headache, fatigue, sleep disorder, weakness, hyperventilation/dyspnoea, tremulousness, sweating, anxiety/palpitation, dizziness/vertigo, pre‐syncope/syncope etc. At least 3-5 of the above symptoms should be present together with signs that can only be identified by a doctor or health care provider while examining you.
It will be wise at this point to stop your current medication especially the nadolol (which is a beta blocker that precipitates and aggravates POTS).
I believe that you seeing a doctor at this stage is paramount and you should try getting an appointment ASAP.

Hope this helps and if you have any further questions, do not hesitate to write back.
Dr. Nsah