Is This Really A Negative Ttt? Cardiologist Says So?

[GN1978]

Finally got my TTT results assessed. I have today received a report/letter from the cardiologist noting that during the TTT my base line HR was 112 bpm (this is higher than normal, maybe a bit anxious because of the imminent TTT) and that my HR increased to a maximum of 155 bpm.

The letter concludes that "this is a negative TTT".

Is it though? My understanding was that POTS was diagnosed by an increase from supine HR to standing HR of over 30 bpm, or when the standing HR exceeds 120 bpm?

My tests appear to show that both of the above have occurred, but says the TTT was negative. This doesn't appear to correspond with the above diagnostic criteria?

I'm relieved to (potentially) not have POTS, but confused at the same time as I'm still feeling rotten, still getting symptoms, and now feel like I'm back to square one as to what's causing these symptoms.

Options? Seek a second opinion? Back to my GP (who'll probably just say stress or anxiety)? This also puts me in a predicament regarding work, as I've been off for a while, and they may think I'm trying to pull a fast one as I've now been diagnosed as non-POTS.

Frustrating!

[BeforeTheMorning]

The increase in heart rate does look like POTS, but I think some people say that you have to experience symptoms as well as having the increase in heart rate to get a positive test.(If this isn't right, somebody who knows more than me please correct me ) Did you experience any of your other symptoms during the test, e.g. lightheadedness?

[GN1978]

Yes. Throughout the test. The report says that at the times I was reporting being symptomatic (which was pretty much throughout the test - 40 minutes of ****!) there was no abnormal HR readings.

Not sure if that's led to the negative TTT finding?

[BeforeTheMorning]

Maybe. I've just thought, how long did it take for your HR to increase to 155bpm? Because I think to really classify as POTS you're heart rate is meant to go up 30bpm in the first ten minutes of the test.

[MomtoGiuliana]

That does seem frustrating -- your results do seem to meet the diagnostic definition of POTS. I think it would be reasonable to express this concern to your doctor, with some back-up information from a reputable medical source. But questioning does not always go over well with physicians, and you may have to seek a second opinion from another specialist. Is the cardiologist an expert in electrophysiology or otherwise have experience treating autonomic dysfunction? Generally an EP, or a neurologist, diagnose POTS, although other doctors may as well, they may not be as knowledgable.

I hope you can get answers and treatment soon,so that you can feel well enough to return to normal activities.

[Chaos]

I agree with MomtoG above....you certainly seem to fit criteria. I know my POTS neuro says you need to meet the HR criteria as well as having other symptoms but you seem to have those as well. Can't imagine any physician who truly knows POTS saying that your TTT doesn't meet criteria, but I had a similar situation with my local cardio who didn't recognize my initial TTT results as POTS. I ended up having to travel across country to see a specialist to get an official diagnosis.

Sorry you are having to deal with this stress on top of not feeling well. That's really frustrating!

[Chaos]

Dysautonomia specialists also recognize what's called "delayed accentuated tachycardia" which can occur if your heart rate increases (or continues to increase) beyond the first 10 minutes. You can have POTS and the delayed acc. tachy as well. It's all part of the whole spectrum of dysautonomia I believe.