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Fluctuations in heart rate


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So I've been on Florinef for a few weeks (very low dose, like .5) and it seems to be working well with keeping my tachycardia under control. Now that I've been logging my heart rate, I have been seeing some odd behaviors and wonder if its normal for POTS and if any of you experience it.

Sitting down my heart rate will stay around 60-70 depending on my posture. However if I move my arms above my head or take a sip of water, my heart rate jumps to the 90s. After a few moments though it will drop back down to 60-70.

I see the same thing with standing now too. Once I stand up it hits about 100 or so depending on how long I sat and then it gradually goes back down to 70s-80s within about 30 seconds.

Why is my heart rate jumping around so much? Is this normal?

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I'm waiting to see a specialist for a diagnosis, but my heart rate goes crazy when I'm up.  I didn't realize just how much until I got a FitBit.  My sitting rate is generally in the 90s (bpm), and standing it jumps up to 110, 120, 140, etc. depending on the day and how long I stand.  If I walk 20 feet it will instantly go to the 120s - 150s.  If I try going up or down stairs in my house, I'm really screwed (I frequently hit the 160s and 170s then).  Generally, my heart rate drops as soon as I lay down.  Sometimes it takes a bit more time.  I've had a heart ultrasound and 2 week Holter Monitor test...there were no abnormalities as far as structure and rhythm go.

Having my arms above my head is one of the absolute worst things I can do to myself.  I used to have really long hair, but recently cut it to my shoulders because having my arms up to brush it, put it into a ponytail, etc. was way too hard on me.  I instantly get really shaky, weak, etc. and my heart rate rises.  I tried to use a roller to paint my son's bedroom ceiling a couple of months ago, and instantly felt really unwell and started sweating/shaking/weak....my partner heard my (laboured) breathing from the next room and took over.  

I've been told that arms above the head can make POTS worse because all of the blood flows from your arms to your lower body.  I'm not sure if that's right or not, but it made sense to me.  


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Hi, goodr189,

This is taken from our "What to Avoid" page from the main site. "Holding the arms up in the air can cause problems for some individuals. Holding the arms up requires the heart to work harder to counteract the effects of gravity. This is especially difficult for the heart if there is already excessive venous pooling in the lower limbs. The heart may not be able to effectively pump blood up into raised arms and tachycardia will result from its effort."



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You should check with your doctor but what you are describing does not sound unusual. The HR increases with any kind of activity, even for normal people. For people with POTS, the response might be exaggerated.  The good news for you is that your HR goes down when you stop the activity -- and it seems to do so very quickly.  At my worst POTS, my HR would never restore to the baseline after activity.  It can be helpful to monitor your HR with POTS - but there is also the danger of worrying too much about each fluctuation.   It probably does not make sense to be concerned about the numbers you are reporting, unless your doctor says there should be a concern.

Draven, the fitibit HR numbers are not accurate -- this has been in the news lately.  A polar HR monitor with a strap (or another ECG accurate device) would be a better measure. 

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Thanks Yogini!

I've been comparing the FitBit with readings from my blood pressure cuff, and by manually taking my heart rate.  I find it's accurate for my "lower" heart rates, but when my heart rate goes high, it tends to record it as lower than it really is.  It also has a hard time adjusting when my heart rate suddenly spikes....there will be a lag for 5 or 6 seconds (or longer) where it says my heart rate is low (maybe 106 bpm) when in reality it is in the 160s.  I figure it give a decent idea of what's going on, but not something I would rely on for pure accuracy.  

Does monitor with a strap mean it will have the chest strap?  


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