Although the study was small, the results were dramatic and encouraging. People suffering from the so called “Grinch” syndrome, known medically as Postural Orthostatic Tachycardia Syndrome or POTS, respond better to an exercise regimen than they do to the traditionally prescribed beta blocker medications. POTS affects roughly 500,000 Americans, most typically young women. The condition is usually discovered during the teens but may go undiagnosed for several years before symptoms become problematic. The condition got its nickname, the Grinch Syndrome because the hearts of the patients are considerably smaller than those of the patient’s peers.

Common symptoms of POTS include dizziness or lightheadedness upon standing and can include fainting in some cases. Fatigue and the inability to stand up for any length of time is also frequently seen and can cause disabilities for many of the people that have the condition. It is caused by a dramatic increase in the heart rate when the person moves from a lying down position to a standing one. The heart rate goes up with palpitations but the amount of blood actually being pumped remains low. The heart rate can go as high as 120 beats per minute, even without physical activity.

In a very small study, researchers used a double blind drug trial to compare the effects of the beta blocker, propranol which is typically given to POTS patients as well as a controlled exercise program. Some of the patients got the drug while others were given a placebo instead for the first four weeks of the study. The second half of the study began with three months of exercise that was carefully structured and monitored.

All patients did benefit from the exercise, with all of them showing some improvement in their physical function scores. All of them also showed an improvement in their heart rate response with over half of the study participants being cured of the condition by study’s end. In addition, 95% showed an improvement in their social function test as well. That is encouraging because so many of the patients are disabled, unable to function in their daily lives.

The exercise program used during the second half of the study involved recumbent exercise for the first two months because symptoms are typically seen while standing. The patients were asked to exercise for 30-45 minutes, two to four times each week and then gradually increased their intervals, duration and frequency, working up to five to six hours per week. By the end of the training sessions, the patients are typically able to handle working out in a standing position.

In addition, the aldosterone to renin ratio was also improved after the exercise. This ratio is important in the regulation of sodium balance, fluid volume and the blood pressure. This ratio started and remained low with the patients using the beta blocker treatment.

The study might be repeated on a larger scale and may also be expanded to investigate how the treatment plan could benefit other heart patients.