Heart Rate Decreases then Increases POTS

[Sam4877]

Hi All,

I have POTs symptoms and what happens sometimes is when I stand up or sit down my heart rate decreases suddenly then starts racing again and when it decreases I get a really bad feeling in my chest where my heart is.

Is this normal with POTs? Because I thought in POTs the heart rate only increases, but in my case it decreases and I get a pounding sensation then it increases again.

 

TIA

[Pistol]

@Sam4877 - there are several possible causes for what you describe, and only a heart monitor can truly identify what is going on. I have HPOTS and NCS, and for me the HR increases rapidly when standing up ( the POTS part ) and then can plummet so suddenly that I pass out ( the NCS, or neuro-cardiogenic-Syncope part ). Another thing that happens to me - and causes chest pain when it happens - is that sometimes I experience premature beats ( called PVC's ) that will cause skipped beats that resume in fast and hard beats after a pause. If there are more than one skipped beat in a row ( I sometimes have 4 or 5 in row ) then this can cause what appears a slow heart beat and it can cause chest pain. As I said - to make sure you should notify your doctor and have a monitor, TTT or even standing EKG performed. 

[cmep37]

I echo everything @Pistol says - you really need to have what's happening picked up on a monitor to find out exactly what's going on.  Having said that I do occasionally experience what you are describing when I first get out of bed in the morning - when I was wearing a 24 hour Holter monitor I had an episode when i got up where my HR went from around 60BPM to 160 to 50 and back to 150 again inside the space of a minute.  My cardiologist didn't seem too concerned as it was all sinus rhythm and thought it was probably due to fluctuations in BP - unfortunately I wasn't wearing a BP monitor as well.  For me it is accompanied by shortness of breath and chest discomfort (like someone is squeezing you).  When it happens I generally lie down again, drink another 500ml of fluid (I always drink 500ml before I get up) and try again!