Tilt Test Table, Hyperadrenergic Pots, And Others

[Guest danielvasel]

i just got back from the TTT... i felt awful... nauseated, weak, etc..... my heart rate was "ok", an average of 110bpm

but then they gave something, i think it?s called nitroglicerina, or nitrolingual... then I almost passed out(maybe I did for a little while, not really sure)... my BP was low, it got as low as 71/40... but most of the time it oscilated between 110/70 and 90/40... did the same thing happened to you gals? what was your average BP, and how low did it get?

i may be totally off, but I was happy to see that my BP goes down rather than up, because I read somewhere that in the case of hyperadrenergic POTS the pressure usually goes up.... is that always the case? or could I be a "hyperadrenergic POTSy", even if I have orthostatic hypotension, rather than hypertension?

(by the way, the reason I don?t want to be a "hypera....potsy" is because they are the ones who have the poorer prognosis....)

how could I know for sure i?m not a "hyperad... POTSy"??

there are other things(less important ones) that I wanted to share with you(about my ttt) - this is just for curiosity purposes, if you don?t feel like it , don?t even read it...

I?m used to get dizzy, and have the feeling that I?m almost fainting... and everytime I have it, everything turns black.... but today, when i almost fainted during the ttt, everything turned white!! it was strange, it never happened before... do you have any ideia of why that happened? could it be related to the nitroglicerina they made me take?

what happens when you are about to faint? what colour do you see, black or white?

the test only went on for 40 minutes... wasn?t it supposed to last longer than that?

i was in a SEMI-orthostatic position(70 degrees)... was it the same for you all?

so thanks a lot for reading my post girls

take care

daniel

[Dizzy Dame]

I've been told I'm borderline hyperadregenic, but my BP usually goes down, sometimes less than 20/10 mmhg, sometimes more. Not event the experts understand why this happens to me...go figure.

[Lulu]

daniel,

sorry the TTT was hard for you. it generally is for a lot of us. hope you feel better!!

just wondering where you found that hyperadrenergic POTS has poorer prognosis??

could you please point me to that info??

best wishes,

lulu

[Guest danielvasel]

just wondering where you found that hyperadrenergic POTS has poorer prognosis??

could you please point me to that info??

hey lulu!!!

yeah, i read about it a few times,

one of the articles that talk about it: www.medscape.com/viewarticle/522421_5

you have to be a member to see it, so im posting it in here

"Prognosis

There is only limited data available at present on the prognosis of POTS patients. We are still in the process of following patients and analyzing their outcomes. Nonetheless some general trends have been noted. In patients suffering from postviral onset POTS, roughly one-half will make a good practical recovery over a 2–5 year period. Here, we define recovery as the relative absence of orthostatic symptoms with the ability to perform the normal activities of daily living with little or no restriction. However there are some patients that will not enjoy this degree of recovery and occasionally patients experience a progressive decline in functional status over time. In general, the younger the patient the better the prognosis. In adolescents with the "developmental" form of POTS, approximately 75% will experience a significant recovery by the time they are in their early to mid-twenties. The vast majority of patients (~90%) will respond to a combination of physical therapy and pharmacotherapy.Patients with the hyperadrenergic form of POTS usually require treatment indefinitely. The prognosis of patients with the secondary POTS syndromes is usually determined by the prognosis of the underlying causative disorder."

take care lulu....

daniel

[dano2718]

Hi Daniel -

I can tell you are very determined by the fact you have already gotten a tilt test ordered despite family, doctors, and fatigue adding to your stress. That's really great! You are also trying to think a lot about this. In other words, you're a lot like me . If you do have to deal with POTS for a long time, you will realize that you can only extrapolate so far about what you think is going on without having more laboratory results - i.e. whether you are hyperadrenergic or hypo-, and what the prognosis is. It just takes time, a lot of time.

As one of the "guys" here - I'll just put my TTT results - had a supine HR of 56 and a max orthostatic HR of 107. So the delta was around 50 BPM. BP was pretty well stable at 115/70. Did you know what your starting heart rate was? The change in rate is the most telling. But you also had a systolic drop around 20 mm Hg, which indicates orthostatic hypotension, which can occur in POTS too.

Keep up the good work, and be patient!

[ramakentesh]

Actually a postural increase in blood pressure isnt indicative of a certain subvariant of POTS - it is just a symptom - some people experience an increase some a decrease - but a normal body maintains the same blood pressure.

Most POTS patients have hyperadrenergic POTS - or POTS caused by norepinephrine reuptake impairment. This MAY cause postural increases in blood pressure but ti can also cause the opposite.