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Posted

I went to an electrophysiologist last month and he had a tilt table test done (among other tests). The problem I ran into was that it turns out he is not on my insurance list of dr.'s so I am going to go to a new one.

The old dr. sent my test results directly to me to take to the new dr. This is the first time I have seen them. Here is a quote from the tilt table results:

Prodedure: "Baseline heart rate and blood pressure were recorded at 116BPM and 120/80. The patient was then subjected to 80 degrees upright tilt table testing for a total of 30 minutes. Upon tilting, the patient's heart rate immediately increased to a maximum of 170 BPM while maintaining normal blood pressure. The patient did feel sick to her stomach. She was returned to the supine position with complete resolution of symptoms"

Impression: "Significant orthostatic sinus tachycardia response without significant drop in blood pressure. However, there still remains the possibility that this could be a variant of postural orthostatic tachycardia syndrome. Clinical correlation is advised."

What do you think?

Posted

Sounds like me. I do not have huge BP drops. The diagnosis is based on the tachycardia, not the BP drop.

However, I have unofficially been diagnosed with POTS, using the poor man's tilt (laying flat, then sitting, then standing, w/ BP measured after a minute in all three positions. My heart rate increase from 60 to 130 was enough to convince my neuro.

Having the diagnosis is of no importance to me, except that I found this site (but I had done that before seeing the neuro). It doesn't mean something else isn't wrong with you, and since the treatments are comfort-oriented, it doesn't help a whole lot to secure a diagnosis. The only other case in which it might be important is for SSDI.

Amy

Posted

I have the same results. My blood pressure does not drop, but my heart rate increases. I was told that I did have POTS. I have never fainted, and I think it is because my BP does not drop. I did have a very low BP when they did a 24 hour monitor.

I have been put on Midodrine, and it has helped. The beta blockers made my BP too low, so they did not work. I hope you can get some treatment.

Rhonda

Posted

Thank you! The last dr. I saw was possibly wanting to do a sinus node modification at some point. I know that that's a no-no. Hopefully this new dr. will know what he is doing. His name is Schloss and he is in Cincinnati.

Posted

Be careful with the sinus node modification. However, it is interesting to note that your blood pressure remained constant. I wish I could stand 30 minutes like you were forced to do on the tilt.

I would suggest you explore POTs treatments, such as midodrine or mestinon or even a beta blocker or calcium channel blocker before doing something permanent and potentially non-helpful like a sinus node ablation.

Good luck with your new doctor.

Lois

Guest tearose
Posted

Oh!!! :)B):(

I am not a doctor however you sure sound like you have some type of POTS.

Please request lots more testing with a specialist of the ANS to know what is happening to you!

It could be that this doctor is the one but ask.

There are so many variations of POTS...

There are different times and conditions that will show when you have more symptoms.

Do you sweat?

Do you have digestion problems?

Were you well rested before the tilt table test?

Here is why I get a little frustrated about a simple TTT and no other tests...

Before I knew I had POTS, I was doing a TTT and during the test when I felt weak, like I was tired and about to fall asleep or fall down, I would squish my muscles in my calves to "wake myself up"....I learned six years later that this is a way to compensate and raise my own blood pressure. I didn't realize that while I was doing my first TTT.

The doctors doing that first TTT did not tell me not to do any compensation techniques and I only learned later during a complete ANS workup how much compensating I was doing on a constant basis to get through life!!!

Just try to get a complete workup before trusting any diagnosis. The diagnosis will determine what measures you will need to take to live a quality life again. Don't settle for less that best for yourself!

Posted

My test results were similar although I had mine done in a autonomic lab in Cleveland..I had reduced sweating and digestive issues. My bp just did fluctuations and did go somewhat low but stayed within the norm. My daignoses was POTS. So I am not a medical personnel but it sounds like it to me.I had a large increase in Heart rate like you..

Also, I had an ablation done in 2000 remember that it is irreversible and permanent. And some of the autonomic docs I have seen have said that I should have never have had that done..although that is not the case in everyone I am sure.This was done before they knew I had POTS.

I would just be a little more cautious and start with meds. if you can..

Good luck dear..Belinda

Posted

You do not need to have a bp drop to get a dx of POTS. From the DINET info page on POTS, here is the criteria:

"Postural orthostatic tachycardia syndrome is defined by excessive heart rate increments upon upright posture. A person with POTS will experience heart rates that increase 30 beats or more per minute upon standing and/or increase to 120 beats or more per minute upon standing (Grubb, 2000). These exaggerated heart rate increases usually occur within 10 minutes of rising."

Nina

Posted

I have yet to hear of anyone who has had an ablation that alleviated their symptoms, and this includes people from another site I visit where the patients have high heart rates in general and not POTS. I'd be very wary of doing an ablation.

Amy

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