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Is it POTS?

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Hello,  I am new.   I think I may have POTS.  I was wondering if anyone may answer a few of my questions.    I did the standing test last night, this morning and again this evening.  Both of my evening test were high and the morning test was not.   This morning my test:  56-hr supine - went to 110-hr standing in ten minutes.    This evening:  56-hr Supine to 133-hr while standing for 10 minutes.   When I lay back down my heart rate recovers to normal within 2 minutes.  However, if I walk right after the test my heart rate skyrockets to 145-150 with in just a few minutes at which time I need to set down.  My Resting HR is fine, even low 49-58, while laying down, and as low as 36-38 while sleeping.  My EKG and Echo were fine.

Question 1. Do you need to wait a certain amount after eating to get an accurate test?

Question 2. Could this be anxiety?  Even though the HR doesn't increase until I stand up and goes back to normal when i sit back down.  

Question 3.  Anyone know of any Doctors in the Kansas City Area that specializes in this?


Thank you for your time.

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Welcome to the forum.

You can find a summary of POTS here:

DINET maintains a list of physicians here.

Eating or drinking fluids could affect your results.  However I do not believe the tilt table test (which tests orthostatics) typically requires fasting.  Fluids could improve the symptoms.  For some people eating can make POTS symptoms temporarily more severe.

From what I understand anxiety does not cause orthostatic problems.  Many POTS patients do initially get diagnosed with anxiety though.

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The instruction book for my blood pressure/heart rate monitor recommends not eating, consuming caffeine or exercising in the 30 minutes prior to taking a reading. Eating can make a big difference for some people but not make much difference for other people.

Temperature and recent mild physical activity can also be big factors.

For example, I recently had some readings on the same day of:
5.00am   51 to max of 81 within 10 min at 13 degrees centigrade
9.00am   46 to max of 90 within 10 min at 15 degrees centigrade
1.45pm   47 to max of 114 within 10 min at 21 degrees centigrade
4.45pm   82 to max of 149 within 10 min at 20 degrees centigrade, 5 min after walking 10 min to the shop and 10 min back with some milk
5.10pm   78 to max of 132 within 10 min at 20 degrees centigrade, 30 min after walking 10 min to the shop and 10 min back with some milk
8.10pm   59 to max of 117 within 10 min at 18 degrees centigrade

In my experience, doctors tend to jump to conclude that an increase in heart rate is anxiety/panic attacks even if the patient says they are calm and don't feel at all anxious when it happens. My heart rate increases don't coincide with any feelings of anxiousness, worry, panic or concern, and I can take a reading every 30 seconds alternating between lying and standing with the heart rate going, for example, back and forth between 40s and 90s each time. It seems to me that anxiety could not be switched on and off so quickly to repeatedly get my heart rate back to the 40s, or whatever starting point it was at at the time, upon lying down.

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