Does your tachycardia only happen right after you stand up?(POTS)

[jeff_jefferson2]

Can anyone here elaborate on your tachycardia episodes? Is it every single time once you get up from sitting or laying? Do you have to be laying or sitting a certain amount of time before you stand up  to get tachycardia? Can someone still have POTS if they don't get tachycardia upon standing but rather at random times throughout the day?

[Pistol]

Welcome to the forum, Jeff! Usually POTS causes tachycardia upon standing ( which is orthostatic intolerance ) but you CAN get it other times as well. In order to be diagnosed with POTS it has to go up within/for 10 minutes of standing. However - many of us ALSO get random episodes of tachycardia during the day. If your tachycardia is not specifically triggered by standing then there might be something else causing it, including ( but not limited to ) arrhythmia. If you suspect POTS you should ask your doc for a TTT. To determine the type of tachycardia you should have a halter monitor over several days or even weeks, depending on your docs opinion. 

[StayAtHomeMom]

For me it is every time I stand. But the amount varies. It is at least a 20bpm difference though (without meds). I can have episodes of tachycardia while laying down but it is usually after I standing and it is just taking a while to come back down. 

There are other conditions that cause tachycardia at seemingly random. Tachycardia is a symptom of of many things. The defining symptom of POTS is tachycardia with positional changes. 

[statesof]

Hi Jeff, similar to the above ^ I also find it occurs every time I stand, sometimes it is worse than others and doesn't matter if I'm standing up from a chair or from lying down; typically from lying down flat the heart rate jump is a bit worse. I also can get tachycardia randomly throughout the day, to me it just feels like my heart can just become tachycardia very easily - anxiety, and various types of psychological stress and I can just feel my heart rate reacting more so than the rest of my body. 

[jeff_jefferson2]

So to everyone who gets tachycardia when you stand up, does this happen every single time? Are there other types of autonomic disorders that would cause random episodes of tachycardia?

[Pistol]

Until I was properly treated with medication yes - I had tachycardia everytime I stood up. Random episodes of tachycardia I guess could potentially be dysautonomia but not POTS. It could be IST or other tachycardias that can be detected with halter monitor. 

[StayAtHomeMom]

6 hours ago, jeff_jefferson2 said:

So to everyone who gets tachycardia when you stand up, does this happen every single time? Are there other types of autonomic disorders that would cause random episodes of tachycardia?

Yes. I imagine there are other types of dysautonomias that would cause it to be at random times. In theory dysautonomia is a dysfunction of anything that your body regulates automatically. That being said there are many reasons why someone could have tachycardia. That's why doctors usually rule that stuff out. 

[jeff_jefferson2]

Thanks for the replies. I told my electrophysiologist that I don't notice an increase in heart rate upon standing but rather episodes at random times and a fast heart rate upon exercise. He still wants me to have autonomic testing done to rule out POTS.

[Pistol]

@jeff_jefferson2 - I am glad your cardiologist takes your symptoms serious and is willing to test you. Most of us are not in that capable of hands! - Elevated HR upon exercise is normal and expected, desired actually! A healthy individual will try to achieve a certain HR through exercise for cardio-vascular health. The concern comes in when the HR goes up to extreme levels WITHOUT exercise - simply from the act of standing/talking/coughing/walking - even sitting, and WITHOUT any recognized arrhythmia. --- Good luck with your testing!!!!

[StayAtHomeMom]

6 hours ago, jeff_jefferson2 said:

Thanks for the replies. I told my electrophysiologist that I don't notice an increase in heart rate upon standing but rather episodes at random times and a fast heart rate upon exercise. He still wants me to have autonomic testing done to rule out POTS.

Have you had IST ruled out yet?

[jeff_jefferson2]

On 10/10/2018 at 4:30 PM, Pistol said:

@jeff_jefferson2 - I am glad your cardiologist takes your symptoms serious and is willing to test you. Most of us are not in that capable of hands! - Elevated HR upon exercise is normal and expected, desired actually! A healthy individual will try to achieve a certain HR through exercise for cardio-vascular health. The concern comes in when the HR goes up to extreme levels WITHOUT exercise - simply from the act of standing/talking/coughing/walking - even sitting, and WITHOUT any recognized arrhythmia. --- Good luck with your testing!!!!

Thanks for the response. I should have clarified that my HR goes up pretty quick with minimal exertion.

On 10/10/2018 at 5:19 PM, StayAtHomeMom said:

Have you had IST ruled out yet?

A cardiologist mentioned IST  to me but it's my understanding that random episodes of tachycardia doesn't mean I would have IST. A lot seems to be unclear about IST!

[kafie]

I don't get the diagnostic criteria every time (increase of bpm 30+ or over 120bpm). I think some of that's that the body will try to compensate with swaying, twitching, or tensing the legs (the muscles help the veins push blood).

I had the same question but the doc still diagnosed me with POTS - just not a severe case.

Over the years I've learned that there's a lot of little things that I do (sometimes unknowingly) that reduce the dizziness - like leaning forward (I always did it because I stand up and feel fatigued or nauseous a lot, but I realize how that this is lowering my upper body slightly, making it easier for the blood to get back to my brain). Walking (when the attack is light) also helps, for the same reason as tensing the leg muscles. These things seem to reduce the tachycardia for me and I think are responsible for why I don't get the numbers every single time (that said, every time I have an attack my heart rate is around 140 (usually 70-90 resting).

I do get tachycardia at other times too, but the lightheadedness does always involve a posture change.

Sometimes my heartrate drops really slowly and I think that might also contribute to why I don't always see a 30bpm increase (in that my heartrate hasn't gone back to resting before standing, which seems to be more common on days when my symptoms are worse).

As everyone said, there's several different types of dysautonomia and various underlying causes. I'm glad your doctor's looking in to it.

My GP passed it off as anxiety and other docs were stumped about my other symptoms (like nausea). Took me several years of educating myself to even be able to figure out that POTS was a likely cause (which I even wrote off for a long time because I didn't have enough information to look for signs (like the blood pooling... didn't occur to me that this could be something that comes and goes and I needed to stand for a minute to really see it).

Wishing you the best of luck!

[yogini]

I can have tachycardia at any time, sitting, standing or laying down.  It doesn't happen every time I stand, but probably more often than not. The biggest triggers for me are being in an upright position and activity.

[jeff_jefferson2]

On 10/12/2018 at 2:27 PM, yogini said:

I can have tachycardia at any time, sitting, standing or laying down.  It doesn't happen every time I stand, but probably more often than not. The biggest triggers for me are being in an upright position and activity.

And were you diagnosed with POTS?

[yogini]

10 minutes ago, jeff_jefferson2 said:

And were you diagnosed with POTS?

Yes.  

[WinterSown]

I get an attack when I stop moving or change position. So like, a zillion a day. 

 

[jeff_jefferson2]

On 10/13/2018 at 3:17 PM, yogini said:

Yes.  

Can you elaborate on how you were diagnosed and what your episodes are like?

On 10/14/2018 at 5:18 AM, WinterSown said:

I get an attack when I stop moving or change position. So like, a zillion a day. 

 

What are your episodes like and how were you diagnosed?

[yogini]

3 hours ago, jeff_jefferson2 said:

Can you elaborate on how you were diagnosed and what your episodes are like?

What are your episodes like and how were you diagnosed?

I was diagnosed through the tilt table test. That is the most common test for Dysautonomia. It seems extremely common for people with POTS to have tachycardia in all positions, not just upright.  I haven’t heard of too many people, if any, that only get it when they are standing.

[jeff_jefferson2]

20 minutes ago, yogini said:

I was diagnosed through the tilt table test. That is the most common test for Dysautonomia. It seems extremely common for people with POTS to have tachycardia in all positions, not just upright.  I haven’t heard of too many people, if any, that only get it when they are standing.

Interesting. Several people in this thread say it only happens when they stand up. What was your tilt table test like? To my knowledge, there are different types of tilt table tests. I recently had an Autonomic Reflex Test (ARS) It was 2 hours worth of testing and there was a tilt table part. However, it only raised me 1 time from a laying position to a standing position. I stood up straight for 10 minutes and by the 9:30 mark, I felt faint, dizzy, and very light headed. How is this any different from standing on the ground? I have never felt like that from just standing.

[yogini]

You may want to search through old posts and you will find lots of examples. Someone else just posted a new thread about fainting while sitting or lying down. There are also many posts on waking up in the middle of the night with tachycardia.