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Interpreting Tilt Tables and testing Beta Blockers


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Hi all,

Just wanted to provide another update and ask for some feedback.

I finally had my Tilt Table last week and am still awaiting the written report, but was essentially told at the hospital that the test assesses the patient's tendency toward vasovagal syncope, and that, since I did not exhibit any of the related symptoms, my test was "negative." However, the nurse practitioner overseeing the test did mention that my heart rate increased from 72 bpm to 137 bpm when the table was elevated to 80 degrees and that it kept fluctuating widely throughout the test. She seemed to think that, since my blood pressure fluctuations were normal and my heart rhythm was stable, I just needed to drink more water and eat more salt and everything would be dandy. Sigh. Of course I have considered and implemented those suggestions in the past, to no avail. Have any others experienced this? (i.e., meeting the diagnostic criteria for POTS and doctors essentially thinking nothing of it.) I'm sure I'm far from the only one.

In other news, the best development of my week was finding a cardiologist who was willing to consider the possibility that I have not, in fact, been consistently dehydrated for the last 18 months and to say: "You have POTS. It's caused by dysregulation of the nervous system, and unfortunately we don't really know more than that and therefore don't have very effective therapies for it." I knew all of this, of course, but for some reason it felt really good to have someone with a medical degree actually say it. I'm testing out Metoprolol and am trying to weigh the benefits/drawbacks, but am only on the second day. Feeling pretty fatigued and a little low in spirits but wondering if that'll improve in the coming days. Did any of you on beta blockers experience an adjustment period?

This latest doctor (whom I like) seems to think that, since I'm a non-fainter and just experience general malaise, tachycardia and brain fog, beta blockers and anti-anxiety meds are essentially the only options.  Is it a good idea to push for other options right now or should I go down the (possibly expensive) road of further autonomic testing that might or might not yield more information? Arrrghh. Big questions I know, and different for each person.





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My HR went up to 180 and I went into hypertensive crisis during my table tilt test so I can't really compare, I will say though that I would get a second opinion maybe.  I would try lifestyles changes as well. Drink more water, watch your BP at home, try different foods/ maybe lose weight if you have to. But if your BP isn't insane and your HR isn't insane I would maybe see a cardio, maybe SVT or IT, which a cardio would have to test for. Which both are essentially high heard rate. Obviously I'm not a doctor, but those were ruled out with me first before they sent me for further testing. Could also be mild POTS, not everyone has crazy BP fluctuations.

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