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Orthostatic Issues with Normal BP


sean82

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I am just curious if anyone here has been diagnosed with orthostatic intolerance even with pretty normal blood pressure readings while sitting, standing etc. I have the symptoms of orthostatic intolerance but when I take my blood pressure it is pretty normal. On tilt test I took a while back, my BP did go up when I was tilte. It went up to 140 something (systolic) and 90 something (diastolic). However, after a good 25 minutes or so my BP had fallen to 114 over 70 something. I also have all the signs and symptoms of dysautonomia. My heart does not seem to race. I am waiting to see specialists, but if I have one more regular doctor do a poor mans tilt test and say Im normal Ill just fake it and pass out haha

But really I am lightheaded within a few minutes of standing. I also have excessive fatigue. Is this just a delayed orthostatic hypotension? My normal BP is 120 or so over 80 when sitting. So when I stood it went up 20 and then dropped 30 but was not evident for a period of time. Hmm any thoughts?? 

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Just fyi, my dysautonomia specialist has ttt equipment that takes constant bp and hr readings. Many only take periodic readings. 

When my original ttt was done (with periodic readings), my bp didn't show anything out of the ordinary.  I did clearly have POTS. However, when my specialist did another ttt (with constant readings), it showed I had sudden sharp dips in my bp that only last for 2-3 seconds. But, he said that's enough to cause symptoms but not enough to get caught when someone takes readings a few minutes apart. 

This might be a consideration for you.

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I have POTS, with blood pooling and hyperandrenergic state.  My blood pressure behaved pretty normally during tilt table testing, but my heart rate increased by about 50 bpm upon standing.  There are many bodily systems that are controlled by the autonomic nervous system, and therefore many possible presentations of dysautonomia.  A specialist will be able to figure out what's going on, whereas a general practitioner may only know basic information.

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Did the doctor give you any diagnosis following the TTT?  Your doctor can tell you best.  I think most people with dysautonomia would have either a sustained increase in HR of 30 points or a meaningful sustained drop in BP upon standing.  Does your HR change when standing? The BP numbers you describe don't sound like dysautonomia to me.

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At first, my issues were POTs. Now I can be standing with a perfectly health hr of like 60-70 and BP 120/70 and feel awful, it doesn't make sense in some ways aha!

I find symptoms also sitting and laying, so I assume its more a dysautonomia than just POTS.

Same boat as you, it *****.

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