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Darla Bennett’s life took an unexpected turn after contracting COVID-19 in December 2021.

Long after the initial infection, she continued to experience persistent fatigue, a racing heart, exercise intolerance and a purplish discoloration in her hands and feet.

“It just didn’t seem to go away, and I realized something was wrong,” says the mom of three. 

Two years later, Bennett was diagnosed with Long-Covid POTS (postural orthostatic tachycardia syndrome), an autonomic condition characterized by a rapid heartbeat upon standing, which leaves patients feeling lightheaded and often short of breath.

Bennett’s early diagnosis was possible, in part, to donors who provided support to purchase the specialized equipment found in the Libin Institute’s Autonomic Lab, headed by Dr. Satish Raj, MD. It’s one of the few centres in Canada that detects and researches complex autonomic conditions like POTS. 

One of Bennett’s symptoms is chest pain, which can feel like a stab or ache and worsens when she is fatigued. She recently took part in a study in the Autonomic Lab that is investigating the cause of chest pain in POTS patients. 

Led by PhD student Kavithra Karalasingham, the study examines whether chest pain in POTS patients may be linked to microvascular angina—reduced blood flow in the heart’s small vessels.

Karalasingham’s novel work combines work in the Autonomic Lab with the advanced tools and technologies found in another Libin Institute resource, the Stephenson Cardiac Imaging Centre. 

Founded in 2005 thanks to a visionary donation from Calgary philanthropist Ken Stephenson, the Stephenson Centre is not only one of the busiest cardiac MRI centres in North America, but it’s also an internationally respected research powerhouse. 

Study participants, like Bennett, visited the Stephenson Centre several times to receive scans after being given a stress-inducing medication, both while in a lower-body vacuum chamber to simulate standing and with MRI-contrast to detect scarring or inflammation. Karalasingham compared results to imaging taken at rest and on the tilt table found in the Autonomic Lab. 

Karalasingham, who is inspired by the patients she meets and interacts with, says its important to understand the cause of the chest pain in POTS patients. 

“Although POTS causes an increase in heart rate, it isn’t always associated with heart conditions,” she says. “It’s important to understand if a patient’s heart function changes when they are symptomatic.” 

Karalasingham’s supervisor, Dr. Raj, agrees, adding the chest pain these patients endure can be quite severe and can limit their ability to take part in activities. 

“Between 40-50 per cent of POTS patients have chest pain, and we don’t know what is causing it,” says Raj, adding it could be an issue with their pain sensing system, microvascular problems or atherosclerosis (plaque build up). “It’s hard to treat a problem when we don’t know the cause of it.” 

The Autonomic Lab is dedicated to finding real-world solutions for patients living with complex autonomic conditions, including POTS. According to Raj, this vital work relies heavily on donor funding. 

Thanks to philanthropic support, the lab recently acquired a new tilt table—a crucial tool used to diagnose and study these often-misunderstood conditions.

“Donor funds are critical for my research and critical for the institute,” says Raj. “Philanthropy helps support scholarships, research and seed grants that generate the data we need to compete for major national funding.”

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