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Heart Rate Increase

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I was wondering if the 30bpm increase is supposed to be laying to standing or sitting to standing.

I know in the ttt they start you out in a supine position, then to upright.

I know that consistently I have at least a 10bpm increase upon sitting, then at least a 20bpm increase from sitting to standing. (Both sustained)

Most of the time there's at least a 30bpm increase upon standing from sitting.

When I test my HR during an attack it's almost always 130-140bpm, which drops down usually to 90, if not 70bpm when I sit down (and very little change from sitting to laying).

I often get a 30bpm increase from sitting to standing, but occasionally it's around 20-25bpm.

My heartrate doesn't even out, it stays high... and there's little to no change in my bp.

Of course, I've had a hard time getting a quiet place to do a real poor man's tilt table test to get the numbers properly.

Of the ones I've done, two had only a 20-25bpm increase, two had over a 30bpm increase with... one of which ended in a faint and not bp cuff errored out because I passed out.

I also found that if I walk slowly, my hr actually drops about 10bpm (if I walk fast or do anything that causes exertion, it jumps up really high). I wonder if this is because the muscle movement is helping pump the blood. My hr shoots back up as soon as I stand still though.

To me, this explains how I do often go from dizzy when standing up to feeling fine as I walk through the room.

I also found that performing the valsalva maneuver causes me to get dizzy and/or pass out. While i'm doing it my hr skyrockets (upwards of 170bpm), but then drops down below my resting hr once i release (down into the 60s-50s - both of which is really weird for me).

I also am starting to notice that if my basal hr is high in the morning or if I get out of bed too quick then I seem to have more attacks that day.


Thoughts? Anyone else have this experience?

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Though only a doc can diagnose you, what you are describing sounds very much like POTS.  Symptoms wax and wane. You don't have to have tachycardia each time you stand.  If you get 30+ often enough ad you see HRs of 130-140s when standing that indicates POTS.

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The only thig I can tell you is that we all have out unique little quirks. In my case I used to go WAY up in both HR and BP when standing but could level out when walking. I do believe it must be because of the muscle pump. I still am better walking but cannot tolerate standing, however - if walking I will pass out if I do it too long. I am sorry that you are having to do the " " "number-game " - meaning you have to worry about the numbers rather the symptoms. But I am sure that if you have an experienced autonomic specialist he can tell you what is what? 

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Walking causes my heart rate to jump. A few months ago I was sweeping my back patio and I jumped to 170 and stayed like that. Through my Beta Blocker. I wear a Garmin and when I don't feel good I will do a quick HR check. It tells me when I need to go lay down. Any kind of exertion cause cause a spike. My BP stays pretty normal. Hydration levels can effect my symptoms. When I am slightly low on my hydration little things can freak it out. For instance, tonight I am playing Diablo 3 on my Xbox with friends and my heart palpitations are going haywire. I am also slightly dehydrated due to overworking and not enough water. It is a constant balancing act. 

I would try to get a TTT as soon as possible. That way the doctors can start treatment for whatever they find. At the very least you have something "funky" going on. 

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I could have written your post, with the exception that I have never fainted and my systolic bp drops by 10-15, diastolic rises, & pulse pressure narrows to about 11-13 before the bp monitor errors out. 

Stairs are a huge issue for me. Walking up the stairs my HR is fairly normal, by the time I get to the top its maybe 100bpm. If I sit down immediately, it might peak at 110-115. If I'm doing something like taking laundry upstairs to fold, as I stand there folding my HR climbs to 170s.  I was doing a daily stand test every morning. I would go from 55-65 supine to 130-160 standing for 10 minutes, and down to 45-55 supine again. 

I just finished up my cardiology workup and the doc says its a "faster than normal response to exercise". Who knew standing perfectly still counted as exercise :D  

To answer your question, I believe the 30bpm increase is from lying to standing. 

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