
Make Visible: Chronic Illness Explored #2 How heart rate and symptoms are connected with Cardiologist Dr Boon Lim
Oct 3, 2024
Dr. Boon Lim, a cardiologist and electrophysiology expert, shares his insights on Postural Orthostatic Tachycardia Syndrome (POTS). He highlights the complexities of diagnosing autonomic dysfunction and the importance of detailed patient history coupled with the tilt table test. Dr. Lim discusses how hydration impacts patients' ability to manage symptoms and stresses the significance of movement for those with POTS or long COVID. His humble approach and practical strategies aim to empower patients, making a significant impact on their daily lives.
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Diagnosis Needs Physiology And History
- POTS diagnosis requires both a sustained heart-rate rise on tilt and persistent daily symptoms for months.
- Dr Boon Lim emphasises history plus tilt physiology over strict labeling for treatment decisions.
Pooling Drives Tachycardia And Oscillation
- POTS symptoms arise from low stroke volume due to blood pooling in legs and splanchnic circulation.
- The body overcompensates with adrenergic surges, causing oscillating heart-rate and blood-pressure responses.
Self-Monitor With A BP Cuff
- Buy an upper-arm blood pressure monitor and perform active stand or NASA lean tests regularly.
- Track your standing heart-rate delta to judge if treatments reduce orthostatic responses.

