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rmlyonsfamily

Help Me Understand Tt Results Please

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Mike's results are posted. Can you tell me what you think and what I need to ask about when the doctor calls?

Results:
1. The underlying rhythm is sinus rhythm at 78 beats per minute.
2. No arrhythmias are noted during the test.
3. Blood pressure and heart rate response to right and left carotid sinus pressure were within normal
range.
4. Heart rate response to tilt demonstrated a hyperadrenergic response. Patient went from a heart rate
of 80 beats per minute supine to approximately 110 beats per minute 10 minutes into the test.
Throughout the test, the patient remained with a heart rate in the range of 120 to 130 beats per minute.
5. Blood pressure response to tilt was within normal range in the early phase. Approximately 10 minutes
into the test, there was mild diastolic hypertension.
6. Patient reports symptoms of arm tingling and feeling anxious with head feeling like it would explode
during the test. Also complained of some dizziness.
7. Heart rate and blood pressure response to Valsalva maneuver with both within normal range.
8. Spectral analysis of heart rate variability reveals a predominant sympathetic control.
9. The baroreceptor reflex sensitivity is normal.
Repeated test post isoproterenol showed similar findings with hyperadrenergic heart rate response to tilt
and a fairly normal blood pressure response.
Impedance Cardiography Findings:
Baseline supine hemodynamics:
Mean heart rate 81 beats per minute.
Mean systolic blood pressure 130 mmHg.
Mean diastolic blood pressure 91 mmHg.
Mean stroke volume 38 mL.Mean stroke index 19 mL/min2.
Mean cardiac output 3.1 L/min.
Mean cardiac index 1.5 L/min/m2.
Mean total peripheral resistance 2683 dyn/sec/cm5.
Mean total peripheral resisting index 5356 dyn/sec/m2/cm5.
Mean upright hemodynamics:
Mean heart rate 112 beats per minute.
Mean systolic blood pressure 127 mmHg.
Mean diastolic blood pressure 88 mmHg.
Mean stroke volume 46 mL.
Mean stroke index 23 mL/m2.
Mean cardiac output 5.2 L per minute.
Mean cardiac index 2.6 L/min/m2.
Mean total peripheral resistance 1571 dyn/sec/cm5.
Mean total peripheral resisting index 3136 dyn/sec/m2/cm5.
Conclusion:
1. Head-up tilt table test shows a hyperadrenergic heart rate response to tilt and some diastolic
hypertension. Patient reports symptoms of dizziness, tingling in her legs during the procedure.

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The doctor would be the best one to interpret the results, but it looks like POTS.

That is a very thorough report. I have had two, but neither were that thorough.

I was a little confused by you addressing the patient as he, and the report addressing the patient as she.

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Like gjensen mentioned it's up to your husband's doctor of course; to me it seems like Hyperadrenergic POTS. His doctor will most likely fill you in on the ins and outs!

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Doctor finally called this morning. Confirmed.... Hyperadregenic (sp??) POTS. D/C'd his Metoprolol b/c she said it's actually making things worse. Started him on Carvedilol 12.5mg 2x a day for 5 days, then up to 25mg 2x a day. We see the doctor May 8th and then will be referred to Dr. Goodman - the Autonomic Neurologist at Mayo (we go to Mayo already).

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Sorry to hear the news but at least they were able to make a quick diagnosis. I have heard really good things about this doctor at MAYO for adults. If you do a search I think you will find some interesting post. Good luck on your appointment in May.

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