My Weird Tilt Test

[BadBadBear]

Is this normally how tilt tests go?

I got strapped to the table, set up for 10 minutes, then back down and giving Iso-whatever, supine for 5 minutes, then back upright for 10 minutes, then back down and given another dose of Iso-whatever, supine for 5 minutes, then back up for 5 minutes. And that was it!

I did not pass out. She said they were checking vasopressor response, and that I do not have it. My pulse went nuts, but I think it was just from the Iso-whatever stuff. My blood pressure was totally steady, which seems to be what happens when I'm stressed - it's ALWAYS normal at the office, but at home this morning it was 80/59 (rechecked it and it really was that low) and I was having pre-syncope.

??? Really frustrating !!!

Thanks!

- Michelle

ETA: the med was Isuprel, blech, worst drug trip ever

[Katybug]

Hi Michelle,

There seems to be a variety of ways that tilt tests are conducted. Mine was carotid massage first. Then, supine for 15 minutes to get resting vitals. Then, 80 degree incline for 43 minutes. I was symptomatic and tachycardic from the 3 minute mark until the end although no fainting. They gave me nitroglycerin at the 40 minute mark and I don't even know what my vitals did because 3 minutes after they gave me that drug, I had severe chest pain and actually felt like my whole body was vibrating hard. I told them to put me down because I really felt like I was on the verge of a heart attack. They would have put me down at 45 minutes anyway. My BP was steady but my HR went from 72 to 145ish and stayed there the whole time.

[BadBadBear]

Thanks Katy! That sounds much more like what I expected - 45 minutes of tilt. At home when I've tried it, I usually start from bradycardia, and it takes my heart a while to hit tachy. I am usually up 35 points in 10 minutes, but that can be just 90 BPM because I start off around 55 BPM - then mine just keeps climbing the longer I'm in tilt.

It seems very unimpressive compared to those of you who are instantly in tachy. Still feels crummy as it climbs up, tho.

- Michelle

[MightyMouse]

I was laid down flat for 10 minutes, then 80 degrees upright for all of 5 minutes before the doctor ended the tests (no meds administered) because they lost my blood pressure at 50/-- and my heart rate was climbing fast, I was just about to faint and they put me down.

At 15 minutes, my cardio said "You failed with flying colors"

[MomtoGiuliana]

My experience was exactly like Nina's, except my bp went very high along w my hr. I am not sure I was upright for 5 minutes tho--I think less.

I think different cardiologists and hospitals administer the test differently.

Hopefully enough data was collected for your specialist to find useful for diagnosis. You may already know, but a POTS diagnosis does not involve syncope, it is based on hr change only. Not all POTS patients pass out.

[MightyMouse]

Exactly. I have two diagnoses--- POTS and NMH

[BadBadBear]

Yeah, I think my docs will only find POTS if it's incidental to the syncope test. I was hopeful before I went in, though... Hopefully I can see the results when I go in Monday. I tried to get them to do a catecholamine test with it, but I couldn't talk them into it.

My doc is probably ready to duct tape my mouth shut...

I don't know why, but for whatever reason I've only ever passed out one time when someone else was present. Usually I pass out when I'm alone and then someone finds me on the floor or I wake up on my own. I kind of wonder if my body fights it off enough not to pass out when people are around me.

[MightyMouse]

My body usually doesn't let me pass out--it gives me plenty of signals to get flat or sit, like shaking, sweating, nausea, tunnel vision, feeling like a huge weight is on my shoulders and upper back, feeling like my legs are full of lead, difficulty thinking. If I ignore all those, then I will eventually drop. The event that finally sent me for my diagnosis was at age 32, mowing the lawn in 90+ degree weather and very high humidity. I passed out on a hill that was visible from my neighbor's home, who saw me drop and lay motionless. Freaked her out more than me. Then later that day, I nearly passed out in the shower (well, I was all sweaty and covered in grass clippings, so I kind of needed one), but my ex was with me and I started yelling from the bathroom to come help me.

I now know better than a hot shower when symptomatic--cool shower better idea.

[BadBadBear]

My last pass out was falling in the kitchen while taking a drink of water. I almost broke my nose on the glass when I hit the floor - I had an impression of the rim of the glass bruised into my nose - and I woke up in a puddle of water and broken glass. That one scared me pretty good.

Yeah, I'd think warm showers after passing out are not good! You must have vasodialated like crazy!!!

Do you usually feel hot before you pass out? Like maybe you flush or something beforehand?

[MightyMouse]

ahahahahhahahaha! I always feel hot!!!! I got teased by my family growing up because I was always complaining "it's hot in here!"and "I feel like I'm gonna puke!"

No one else felt that way, and I should have figured out earlier that I wasn't made the same inside--32 is kind of late to have figured that out, given I had my first full on faint at age 4.