Tilt Test Today

[yuliya]

So I thought my TTT was tomorrow, but thank goodness I checked my calender this morning and it was today.

I was on the table for about an hour before the doctor walking in the room to start the test. My heart rate was around the 70 mark. When he walked in the heart rate jumped to low 90. When they stood me up my heart rate was around 110 mark, and it stayed that way for 18 min. all of the sudden just as I was think "oh well I guess Im all right" my pulse jumped to 158 beats at the 19 min mark. I felt terrible. My legs felt weak, my head was starting to hurt, my vision felt hazy. They laid me down right after that and my pulse came down to 70 beats really quickly. So I only made it about 20 min out of the 45 min. they told me I would have to stand there.

After the test the doctor said he is glad we did the test, but he wasn't exactly sure it was POTS since it took longer then 10 min. for the spike to occur. Doctor said he would call me after he called a few other doctors. Any one have a similar experience please let me know. I thought right after this test I would have a diagnosis but once again I am left to wonder until the next phone call. So frustrating.

[nunntrio]

So I thought my TTT was tomorrow, but thank goodness I checked my calender this morning and it was today.

I was on the table for about an hour before the doctor walking in the room to start the test. My heart rate was around the 70 mark. When he walked in the heart rate jumped to low 90. When they stood me up my heart rate was around 110 mark, and it stayed that way for 18 min. all of the sudden just as I was think "oh well I guess Im all right" my pulse jumped to 158 beats at the 19 min mark. I felt terrible. My legs felt weak, my head was starting to hurt, my vision felt hazy. They laid me down right after that and my pulse came down to 70 beats really quickly. So I only made it about 20 min out of the 45 min. they told me I would have to stand there.

After the test the doctor said he is glad we did the test, but he wasn't exactly sure it was POTS since it took longer then 10 min. for the spike to occur. Doctor said he would call me after he called a few other doctors. Any one have a similar experience please let me know. I thought right after this test I would have a diagnosis but once again I am left to wonder until the next phone call. So frustrating.

Thanks for posting your experience let us know what happens. From what I understand a 70 bpm to 110 bpm is signigicant in itself but I could be wrong. Let us know what the Dr.'s come up with.

[juliegee]

Oh Yuliya-

So happy that's behind you! A supine HR at 70 that rises to 110 DOES meet the POTS DX criteria- 30 BPM rise. IF they altered your starting HR to 90, then you would be 10 BPM shy of the POTS DX. I am surprised that they returned you to the supine position as your HR rose to 158. The same thing happened to my son at the 35 min. mark- THEN his BP became immeasurable, which I suspect would have happened to you if they had let it. I think your heart made a last ditch effort to sustain your BP before it dropped out completely at which point you would have experienced syncope. You were beginning to show the signs...

If I was your doc , you would be DXed with POTS and NMH (neurally mediated hypotension) also know as NCS (neurocardiogenic syncope.) There is also a sub-type of POTS with a late onset rise in HR:

"Delayed forms of orthostatic intolerance have been observed in POTS patients. Some physicians believe POTS symptoms should occur within 10 minutes of standing. However, studies on orthostatic intolerant patients prove that some display a delayed form of orthostatic intolerance in which orthostatic hypotension occurs after ten minutes of standing (Streeten & Anderson, 1992). One study showed that out of 23 chronic fatigue patients, 17 had orthostatic tachycardia alone during the initial period of head-up tilt. However, 22 eventually had obvious orthostatic hypotension after an extended period of time (Bou-Holaigah, Rowe, Kan & Calkins, 1995)." DINET Website/mechanisms.

Best of luck sorting it all out. You definitely demonstrated orthostatic irregularities. Sorry - but hope it leads to a good treatment program.

Julie

[yuliya]

Oh Yuliya-

So happy that's behind you! A supine HR at 70 that rises to 110 DOES meet the POTS DX criteria- 30 BPM rise. IF they altered your starting HR to 90, then you would be 10 BPM shy of the POTS DX. I am surprised that they returned you to the supine position as your HR rose to 158. The same thing happened to my son at the 35 min. mark- THEN his BP became immeasurable, which I suspect would have happened to you if they had let it. I think your heart made a last ditch effort to sustain your BP before it dropped out completely at which point you would have experienced syncope. You were beginning to show the signs...

If I was your doc , you would be DXed with POTS and NMH (neurally mediated hypotension) also know as NCS (neurocardiogenic syncope.) There is also a sub-type of POTS with a late onset rise in HR:

"Delayed forms of orthostatic intolerance have been observed in POTS patients. Some physicians believe POTS symptoms should occur within 10 minutes of standing. However, studies on orthostatic intolerant patients prove that some display a delayed form of orthostatic intolerance in which orthostatic hypotension occurs after ten minutes of standing (Streeten & Anderson, 1992). One study showed that out of 23 chronic fatigue patients, 17 had orthostatic tachycardia alone during the initial period of head-up tilt. However, 22 eventually had obvious orthostatic hypotension after an extended period of time (Bou-Holaigah, Rowe, Kan & Calkins, 1995)." DINET Website/mechanisms.

Best of luck sorting it all out. You definitely demonstrated orthostatic irregularities. Sorry - but hope it leads to a good treatment program.

Julie

Thanks Julie so much for the heads up. when the doctor said "Im not sure that its POTS because of the late on set of the increase" I said "there was different types". Hopefully the resource he uses to finally diagnose me are good ones. I am half tempted to forward exactly what you just said to him. All I want is to finally know what is wrong with me. I'm so tired of always having palpations and extreme fatigue just doing normal everyday things.