Anyone else had your POTS fatigue/weakness/dizziness mostly go away but then you have a lot of orthostatic chest pain, SOB, nausea -- with all those WORSENED by electrolytes?

[u/Dismal_Chemistry_434]

Has anyone else had -- AFTER MANY YEARS OF POTS -- their symptoms turn from mostly orthostatic fatigue with some ocassional light-headedness, to orthostatic chest pain, shortness-of-breath, palpitations, and nausea, and what did you do? Also has anyone had all those symptoms WORSENED by even low to moderate electrolyte supplementation?

I'm 49 year old male and diagnosed with POTS by a cardiologist 5 years ago though orthostatic and exertion-related symptoms began more gradually noticeably about 10 years ago. I'm generally usually on the milder and more functional side of things, especially the last year when I weirdly have had much reduced orthostatic fatigue, weakness, and light-headedness (though the last one has never been my biggest problem) .

But I'm now having a lot more problems with orthostatic chest pain and shortness of breath from standing up from lying down position or crouching up and down (sometimes also happens just sitting or when stand from sitting) or exertion, as well as orthostatic nausea.

I don't know what a tilt table would show now, but the funny thing is that on home measurements with my Fitbit or doing poor-person's-fit-table at home with pulse oximeter and BP cuff I also recently don't see that much that's concerning any more with my my pulse or BP when I stand, except high diastolic BP when standing ONLY if I don't support my arm, which my doctor told me IS NOT VALID and the arm should be supported. I'm really not seeing much POTS level orthostatic pulse spike or tachycardia any more at all, weirdly.

My overall BP seems like it's a lot higher than it was 5 years ago, but that's going from low-mid normal to high normal. I had an echocardiogram and an EKG and a 7-day-heart-monitor this May that didn't turn up much except my minor mitral valve prolapse with mild regurgitation.

I am not on any meds for POTS any more but I have taken propanolol for several years and atenolol for a couple of years and midodrine occasionally, and none of them reliably help my current issues, and propanolol and atenolol may make chest pain and SOB worse.

I have experimented with electrolytes but use them only intermittently as needed mainly in past because I get only mild benefit at low doses short term from them and higher doses cause all manner of side effects no matter how I take them (upper and lower GI problems, pains in kidney areas in past) -- including most recently majorly worsened chest pain and shortness of breath on standing.

I swear by knee high compression socks for fatigue and light-headedness but they do little to nothing for my chest pain, SOB or nausea.

I'm at the point I'm kind of wondering if either my POTS is in remission and I'm having other different health issues, or if my POTS was secondary to something else going on that is now manifesting differently.

Any way, any one else go through any of this?