A question

[gossamer4448]

So is it POTS still if your heart is high when you first stand but comes down in a min or two or when you  walk around ? My hr goes up well past 30 but just for a min then starts to come down. I read somewhere its sustained hr increase .  

[Pistol]

@gossamer4448 - to be diagnosed with POTS a person must have an increase in HR of 30 BPM ( or above 120 BPM ) SUSTAINED within 10 minutes of standing, WITHOUT a drop in BP.

[gossamer4448]

my bp goes up def not low hr goes up right at begining ill check again and it starts to come down . so its not sustained?

 

[Pistol]

@gossamer4448 - to be sure you need to have a Tilt table test ( TTT or HUTT ). If your HR goes up more than 30 BPM sustained within 10 minutes and your BP does not drop ( or even goes up ) it is POTS . To the best of my knowledge. 

When orthostatic symptoms occur in patients, but blood pressure does not fall as much as 20/10 mmHg on assumption of upright posture, the patient has orthostatic intolerance (OI). Additional criteria used for the diagnosis of OI at Vanderbilt’s Autonomic Dysfunction Center include an increase in heart rate of at least 30 beats per minute with standing. Because upright heart rate is usually greatly increased, the term Postural Tachycardia Syndrome (POTS) is also used.

This is from the following website 

https://ww2.mc.vanderbilt.edu/adc/38847

 

 

[gossamer4448]

so for hyper pots tho is the HR usually also high and sustained?

[Pistol]

Yes - if it goes up and then down again it is actually a normal response. It should STAY elevated in order to be POTS. This goes for all types of POTS. In hyperPOTS usually the BP goes up along with the HR. 

[jklass44]

@gossamer4448 From my understanding if you have an exaggerated increase in your HR upon standing PLUS other symptoms such as dizziness, fatigue, palpitations, etc. but then your HR comes back down within a few minutes, this may indicate something like IST. POTS and IST are both not very well understood, have very similar symptoms and therefore makes it easy to misdiagnose one as the other. That being said, I’ve also read that you can have both conditions at the same time.

[bombsh3ll]

My understanding is that if you have symptoms but do not meet the exact criteria for POTS, OH or NCS then it is classed orthostatic intolerance (OI), which simply describes symptoms when upright and does not reference any measurements. All of us have OI as part of our presentation otherwise we wouldn't be having all these things measured. 

I think it is how you feel though that matters more than a label, and if you are having significant symptoms that are interfering with your function and quality of life, they are deserving of treatment regardless of the official diagnosis. 

A lot of the treatment for orthostatic issues tends to be similar in any case, and a lot of it is trial and error. 

B xxx