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Can Anyone Tell Me Why I Was Given Nitro During Ttt?


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Thank you! After the test my doc said it looks as if I have peripheral POTS. Does it sound like the nitro results would have told him that?

ETA: Looked at my test results and my bp fell about 20 to 30 points over the last 15 mins. Started at 132/95 at nitro admin time and got down to 106/75 eight minutes later. Then went from 113/79 to 125/93 in the last two minutes before lying back down.

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What was your pulse reading from lying to standing? The usual standard for a TTT is that your pulse raises at least 30 bpm, from, say, 60 bpm to 90 or over. I was told that when I did the TTT that they would give me nitroglycerin to see if it would produce a response if my own body wasn't doing it on it's own. In my case, I had such drastic numbers they didn't need to use the nitro.

Best,

Jana

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Oh yeah, I know how the diagnosis is made. My pulse went from 74 to about 130. So, 60 bpm increase! More so asking about the nitro's effect on bp I guess. It was obvious in my case that they didn't have to add nitro to get the POTS Dx. But, makes me think they were trying to find out how my POTS operates. Just dont' know what the results I had after Nitro imply.

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Here's a confident answer for you :) . It has been awhile since I read this but I believe the nitro causes the release of adrenalin to simulate working conditions. With it you can identify ncs orthostatic hypotension and provoke hidden pots if the first part of the test is negative. There is debate whether the drug part of the test is really useful. I was told by one doctor that no one pays any attention to that part of the test anymore ( this was after I passed out, turned smurf blue and went into seizures).

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Here's a confident answer for you :) . It has been awhile since I read this but I believe the nitro causes the release of adrenalin to simulate working conditions. With it you can identify ncs orthostatic hypotension and provoke hidden pots if the first part of the test is negative. There is debate whether the drug part of the test is really useful. I was told by one doctor that no one pays any attention to that part of the test anymore ( this was after I passed out, turned smurf blue and went into seizures).

Holy cow! Good to know after you passed out, huh? lol Thanks so much for the info.

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you can have POTS and NCS, perhaps it was to check for NCS. My NCS response to the meds was a huge drop in HR and BP.

from 82/P to O/P or O/palpable, with the HR going from 121 to 46

Wow, that's a pretty low drop. Do you mind telling me what the palpable means in regards to heart rate/pressure? I've heard it before but never thought much about it because I didn't think it pertained to me.

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Palpable means that you can feel something. In relation to BP a "palpable BP" means that the nurse / doctor can feel the pulse at your wrist. Feeling the pulse is often used as a very crude check of BP, if you can feel the wrist pulse then the systolic BP will be 90mmHg or higher.

When doing a proper BP measurement they will inflate the cuff on your arm to above the point where the pulse is occluded. They then listen with a stethoscope over the artery in the elbow crease to listen for when blood flow returns. Different sounds give them the systolic and diastolic numbers (the x over y, eg 120/80).

Doing a full BP with a stethoscope takes up to a minute. To get a quicker reading they can skip the stethoscope bit and just feel for the pulse whilst inflating the cuff. As they let the pressure down, the point at which they first feel the pulse again is the "palpable" measurement. That method is less accurate but very useful to get a quick reading when someones BP is changing such as during a TTT.

The "gold standard" for BP measurement during a TTT is to use beat-to-beat BP monitoring such as a finapress system with cuffs inflated over the fingers. This allows the doctor to see exactly when the BP changes - more important for assessing NCS than POTS but as many of us have both diagnoses it is helpful for POTS too. My local hospital did the TTT using an automatic BP machine that did a measurement every 2 mins. When I went to the specialist autonomic unit in London they used a finapres system.

Flop

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Thanks, Flop!

I'm actually a dental hygienist so I know how to take a standard bp/pulse. I still have my steth and sphygmo from school. I just never looked into what "palp" meant after I heard it in all the shows in like ER and Grey's. Good explination-thanks again.

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