"florid Pots"

[cardiactec]

Who here has been told they have "florid POTS"?

[wareagle]

I have. My doc said it just means that I have an obvious / textbook case of POTS.

[cardiactec]

I was told that florid means a heart rate increase to at least 120 within 2 minutes of standing. Just wondering if there was significance with it as I think most of us hit that number that quickly. .....

[summer]

Hi Angela,

That is also what I have heard that florid POTS means. And I think you're probably right that that would describe most of us here.

I have also heard that some doctors (possibly mine included) would look for a minimum HR of 120 for a diagnosis of POTS, along with the 30 beat increase. I recently read that a HR increase from 50 to 80 with standing could not be compared to a rate increase from 100 to 130. This was because of chonotropic reserve (I don't know what that is). Do you think that the 30 beat increase alone is enough to diagnose POTS or would there have to be a minimum rate?

I wonder about this because my rate went from 100 to 144 on the TT, and I was given the diagnosis. But I know another person with similar symptoms, TT tested by the same doctor. Her rate went from 60 to 100 and she was not given the diagnosis (she was however diagnosed with CFS). The only reason I can think of that she was not diagnosed with POTS was that he did not think her HR went high enough. Could this be?

[cardiactec]

Hi - I do believe a heart rate to atleast 110 at a 30 point supine increase along with symptoms is important with a true diagnosis of POTS. If you look up "tachycardia" it by definition means a heart rate over 100 BPM so if you want to get technical you could look for a 30 point increase from supine heart rate that reaches over 100 bpm (thus the postural TACHYCARDIA).

I went from supine rates in the 80s and instantly upon upright tilt hit 180-200. The longer I stood the higher it went. Dr low at mayo was shocked with my heart rate as it was literally off his charts. The bp showed low but not hypotensice and wherever my heart rate increased more, it showed my bp starting to drop off (so heart rate was trying to compensate at a very extreme rates).

Florid used to be defined at 150 or greater within 5 minutes. They revised this from what I have found online.

Most potsys I talk to are in that 130-150 range for standing rates. I have met only a handful with rates in the 180-200 range....especially within literally 20 seconds of upright tilt (and sustained rates - not a lag phase or drop off). BOTH though have similar symptoms and symptom wise one doesn't seem worse off than the other when just comparing notes. Dr low seemed quite impressed though and aside from the obvious I was wondering why (hence my poll here on HR's).

[erikainorlando]

I was told too tho that one has to consider age with the hr. If you are 20 and your hr is 200 it equivalent to being 50 and having a hr of 170. 1 point for each year.

That is how they determine max hr for exercise etc. I am 46 and had hr of 188. TTT have varied at times. Once I was supine and it went from 80 to 155 in a matter of minutes.

Last time at Vandy supine it was 69 standing immediately to 100. But I began getting the tremmors and convulsions so bad they had to stop the test. But they told me it still read POTS even if I couldn't stand for more than 1 minute...just the increase of 30 points. And honestly....POTS may be secondary to some other neuromuscular problems for me but I was way way sicker during the 2nd TTT than the first. Perhaps they really didn't get a good read on the hr of the 2nd TTT as I was shaking so much and then convulsing.

I guess I just think the autonomic nervous system is broken...and how high the hr gets doesn't always show the whole picture.

[ramakentesh]

There is some evidence that there is a subset of patients with reduced cerebral autoregulation on orthostatis that doesnt result in tachycardia - are they POS - without the tachycardia?