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Exercise May Help Treat POTS Heart Condition

Study Shows Exercise Program Is Effective for Heart Condition Also Known as 'Grinch Syndrome'

Exercise Program for Grinch Syndrome continued...

"By the end of three months, they were exercising about five or six hours a week," she says. Besides cardiovascular exercise, they added weight and resistance training. Patients could work out upright as they progressed.

Both the beta-blocker and the exercise training lowered the standing heart rate.

But the patients' quality-of-life scores, including social and physical functioning, were better after the exercise phase but not after the beta-blocker phase.

"Beta-blockers slow the heart rate," Levine says. "Doctors love to see that outcome [so] they prescribe beta-blockers. The problem is, it's not the heart rate that is the issue. And that I think is our message: Just slowing the heart rate doesn't make people feel better."

The exercise worked better than the medicine to restore upright blood circulation, improve kidney function and quality of life, all problems in POTS, the researchers say.

By the end of the exercise phase, 10 patients no longer met the criteria for the syndrome.

In those with POTS, Levine says, "this isn’t a pathologically small heart, it's a variation of normal."

Grinch Syndrome: One Woman's Story

Krakower calls the study findings exciting. But she is not certain everyone will benefit. She cites disagreement among the medical community about various other problems besides the heart size and condition that can play into having the condition.

There's also the difficulty of being able to exercise, especially if the condition is not well controlled. In the past, she says, "working out was a nightmare." Her heart rate would jump rapidly, at the very beginning of the exercise session.

The inability to stay upright for long periods compromised her life greatly. "It was a very isolating experience," she says. She went from being a very social person to passing up social outings with her law school friends.

These days, her POTS is under more control, she says, thanks to a variety of medications, including a beta-blocker.

"I do work out," she says. "I have been to cardiac rehab, which retaught me the exercises I am allowed to do."

Studying for the bar, as she is doing now, is very time consuming. But she tries to squeeze in workouts. "I know I do feel better when I exercise consistently."

Exercise Not Fit for All

''What [Levine's] study shows is, if you adopt that sort of formal training, you can get good results," says Blair P. Grubb, MD, professor of medicine and pediatrics at the University of Toledo College of Medicine and University Hospital. He cares for many POTS patients.

Grubb tells WebMD he has seen the same results in heart patients. "No one has every questioned whether exercise can work. All of us in the POTS field emphasize reconditioning."

"I believe there is a significant subgroup of individuals who will be able to complete this very rigorous program. But at the same time there will be some patients who won't be able to do this."

Some patients won't be able to do it simply because they don't feel well enough to exercise, he says. Another potential drawback, he says, is the issue of costs, since the exercise program must be overseen by experts.


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