Lindsay* I loved Alex Trebek and was very saddened by his passing. I mean no disrespect by including his name in the title of this post.*
If you follow the latest news about postural orthostatic tachycardia syndrome (POTS), you may have heard that Monday night’s Jeopardy! episode featured a clue about POTS, albeit an outdated and inaccurate one.
If you’re familiar with Jeopardy! you know that contestants are given the answer and they have to use that clue to respond with the correct question. On Monday’s episode, the answer was “Postural Orthostatic Tachycardia Syndrome is also known as Grinch Syndrome because this organ is too small.” The correct answer was “What is the heart?”
After the episode aired, many people with POTS took to social media to inform Jeopardy! of the inappropriate and outdated use of “grinch syndrome”. Some people found the term offensive. On Wednesday, the official Jeopardy! social media accounts responded to concerns from the community by issuing an apology.
What is “Grinch Syndrome”?
The first mention I could find of “the Grinch Syndrome” is from a 2010 research article written by Dr. Levine and others. That article examines the effects of exercise on POTS. In the conclusion, the article states:
“It seems reasonable to offer POTS a new name based on its underlying pathophysiology – “The Grinch Syndrome”, because in this famous children’s book by Dr. Seuss, the main character had a heart that was “two sizes too small.”..
“We suggest then, that a more pathophysiological name for POTS would be” “The Grinch Syndrome”, emphasizing that a small heart is the primary abnormality and target for therapy.”
If you want to read that journal article, you can find it here.
If you’re familiar with How the Grinch Stole Christmas, the beloved Dr. Seuss book, you may remember the line:
The Grinch hated Christmas! The whole Christmas season!
Now, please don’t ask why. No one quite knows the reason.
It could be his head wasn’t screwed on just right.
It could be, perhaps, that his shoes were too tight.
But I think that the most likely reason of all
May have been that his heart was two sizes too small.
Dr. Levine’s research noted that roentgenographic and echocardiographic tests observed that the heart of participants with chronic fatigue syndrome (term used in the research, or myalgic encephalomyelitis, as it is properly known) and an overlap of POTS had much smaller hearts than healthy controls. Specifically, the left ventricular mass was approximately 16% smaller. This article also concluded that the hearts of ME/CFS patients were smaller than controls.
Is “The Grinch Syndrome” still used today?
Referring to POTS as “the Grinch Syndrome” has fallen out of favor. While some people with POTS do have smaller hearts – in fact, astronauts returning to earth after extended travel in space develop POTS and experience a reduction in heart volume – not all people with POTS have small hearts. My last echocardiogram was in 2015. The results were mostly normal – I have low cardiac output and cardiac index and some mitral, pulmonary, and tricuspid valve regurgitation. And according to my results, my heart size is normal. In fact, the results specifically identify that my left ventricle, right ventricle, left atrium, and right atrium are all normal size. And yet I have been diagnosed with POTS on two separate occasions.
Should we abandon the term “Grinch Syndrome” when referring to POTS?
YES. Clearly the term “Grinch Syndrome” is inaccurate and outdated. I’m not upset with Jeopardy! for including the term in their show – I think their fact checkers were referencing a published article from the Journal of the American College of Cardiology and assumed it was a reliable source. My frustration lies with Dr. Levine and other authors of the study that thought an appropriate pathophysiological name for POTS is “The Grinch Syndrome.” I’m not offended by the term, but if we’re trying to get POTS recognized as a legitimate chronic illness, naming it after an inaccurate feature and unfavorable character isn’t helping that cause. I worry about the people with normal-sized hearts who may have been overlooked and not given a POTS diagnosis simply because they didn’t have small hearts.
What other chronic illness terms make you cringe?
“I think… if it is true that
there are as many minds as there
are heads, then there are as many
kinds of love as there are hearts.” – Leo Tolstoy
Smell ya later.
– Linds
I was completely confused by this description. I’ve had POTS for at least 21 years and have had no indication that any portion of my heart has been less than average-sized, and haven’t heard it referred to in anyone else that way. We really always talk about the functionality.
Yes, exactly! To be diagnosed with POTS, you have to experience a specific increase in heart rate upon standing. There’s nothing in the criteria about the size of the heart.