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songcanary

Heart Rate Variability Test Results - Question?

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At long last I got written results. It took nearly two months! I had an HRV and QSART done at the Cleveland Clinic. I am wondering if anyone could put these results into lay terms. I don't completely understand them. I don't have the QSART results yet. Thanks!

"HRV (ANSAR) and Valsalva procedure showed normal physiologic cardiovascular autonomic reflexes with balanced cardiac sympathovagal modulation of HR in the supine position. ANS dysfunction during sitting due to paradoxical increase of postural parasympathetic response and borderline increase of postural sympathetic response".

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Let me give it a shot until someone more experienced comes along...

When you're lying down, the tests showed that your autonomic reflexes are normal. In other words, your autonomic issues aren't happening all the time, just when you're not lying down (so it's postural). Your sympathetic NS and vagus nerve are properly modulating your heart rate when you're lying down.

When you sit up, your ANS starts messing up, specifically the parasympathetic response (which slows breathing, increases digestion, etc) goes way up in an unexpected (paradoxical) fashion, and the sympathetic response (more the fight or flight, hyper, super wired, rapid heartbeat response) is normal to slightly higher than normal.

Does that make more sense?

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Yes, Peregrine, it does make sense. Thank you for explaining. And since I posted I have been googling it and found an explanation very similar to yours. Apparently there is something called PPS (paradoxic parasympathetic syndrome) and I am wondering if that's what the doc is referring to. Wow, another wacky thing to understand! But it sure does explain why I have hyper responses to stress. And that's an understatement :blink:.

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From what I remember from the cardiac portion of my pharmacology class... The parasympathetic nervous system needs to be active at a low degree to maintain what we consider normal heart rates. Thank you for sharing your test results. I hope your doctors can suggest better treatment based on the results.

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Hi everyone. I think I was diagnosed with PPS as well. My doctor just said that my parasympathetic is overshooting and thats what i need to regulate, based on ansar test. Can I ask what kind of treatment they offered you? I was given coreg, midodrine and amitriiptoline. I started all three of them and reacted really bad, so stopped and now only started coreg and midodrine and then will add on the amitriptolyn if i will be able to tolerate them. Thanks.

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I had this done at CC too and had "normal" HRV results. I didn't seem to get as much data as you in my report but it's been a while so I'd have to go back.

Comparatively while at Vanderbilt I had a similar HRV and learned that while my ANS dysfunction is Postural I learned that I had a nearly 90 pt overshoot in my BP In phase 4 of the Valsalva which is a marked evidence for a hyperadrenergic reaction. (a normal test looks for a 10-15 Pt increase- below that would be "abnormal" meaning the ANS is not properly compensating on it's own- typical results in more degenerative cases of Dysautonomia such as PAF, MSA and Familial Dysautonomia.)

I'm wondering if you received the actual BP and HR Variability data? Also, I was surprised that at CC once I had a "normal" HRV test (even though I likely had a similar exaggerated overshoot) the additional testing such as the cold pressor test and the hand grip tests were not required- so I didn't get them there. If you didn't get the raw data you might want to ask for it. It seems those of us w/ hyperadrenergic cases consistently have a notable BP overshoot in the Valsalva but I haven't seen research material showing that it is a consistent measure. (I just remember Dr. Biaggioni coming in my room, along with a resident, and pointing out to him how exaggerated my Phase 4 overshoot was.)

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