Ttt-if Need Injection To Pass Out Is That A False Positive?

[2manyfurkids]

Had a tilt table test yesterday. Not much fun, like everyone here warned! Was tilted for 30 minutes and just feeling plain yucky, but basically not much change in BP. Heart rate went up about 15bpm. After the injection of isoputerol(sp? imediately felt like I was going to vomit. That was the last thing I remember. When I woke up the cardio nurse told me it was a positve tilt. She said the HR went up to 120 then crashed to 70. She said the fact that I needed the injection to faint could mean a false postive. Is this true? I thought a "normal" person's nervous system is supposed to handle the adrenaline rush and compensate for it? I thought I heard most healthy people don't even pass out during the TTT? She also said it was probably NCS, not POTS. How do know the difference? See the cardio next week to discuss results. If anybody can shed some light on this, I'd appreciate it. Thanks!

[MightyMouse]

People who are normal don't pass out even with the injection. Info on the diagnostic criteria for ncs and pots can be found on the main dinet site.

Nina

[persephone]

It depends. THere can be false positives with tilts even where injections aren't involved.

[MightyMouse]

false positives and false negatives are possible with pretty much any type of diagnostic testing--however, fainting during a tilt, for a person with a normal nervous, muscular and circulatory systems isn't that common from what I understand.

[2manyfurkids]

Thanks. That helps me alot!

[cardiactec]

what your pressure when your heart rate was at 120 and dropped to 70?

[Sophia3]

FalsE positives or negatives sadly, are in the eyes of the interpreter or

doctor reading the tests. The SLOB that was at my TTT called it INCONCLUSIVE even though my HR jumped 55 BPM in about 45 seconds, I got sick as a dog with NUMEROUS symptoms. My real cardiac in the office later said the tests confirmed what I and my ANS doc, an endocrinologist had suspected. ANS dysfuction.

I knew it was POTS but nobody called it by that specific name....well, until I had one visit with dr. Grubb who said it was a no brainer "POTS" dx. aka Orthostatic Intolerance.

Some idiot docs think you need a FAINT to have a positive tilt. NOT TRUE for POTS but many docs "don't recognize pots or ANS problems" w/o an obvious faint.

Also, I have read on many sites that in certain situations HEALTHY people can faint ( I think the site I recently read was using teens on the TTT) This does not help some of us as a faint is NEVER a good thing in my book and I keep getting confused at how "healthy individuals may have a faint on a TTT." ???

Anyway, it's all about HOW YOU FEEL DURING THE TEST, your B/P and HR, and your docs reading of the results.

Where I was tested, the colleague Doogie Howser (there for my then cardiologist that ordered the test) 'Felt" that the injection gave you false positives. Seeing as how this same attending Bozo was an IDIOT at what my results were, I don't give him much validity.

Some docs think TTT are not a strict enough test. True for those who wax and wane or can get out of the house DAILY or still work. In my earlier years, I might have passed a tilt..but for me things have CERTAINLY progressed...and for those of us extremely debilitated, we could flunk a TTT every day.

Interpretation is everything.

[Sophia3]

Blurb from Phoenix CFS site

~~~~~~~~~~~~~~

Tilt Table Testing ? Despite its popularity it is surprising to learn that the tilt table test is not particularly accurate. About 25% of adolescents without a history of fainting will faint during a tilt test. Similarly about 25% of people with a history of fainting will not faint on any given tilt test. The tests reproducibility rate is not particularly high; someone who tests ?positive? on one day may test ?negative? on the next. This field of research is plagued as well by different methodologies (angle of tilt, use of pharmacological challenge or not) that makes it difficult to translate results across studies. It is, nevertheless, the most widely used test in diagnosing OI.

~~~~~~~~~~~~~~

Again, this article is speaking of FAINTERS. I always get lots of notice I need to lie down or fall down but do not faint. Still, many fainters do not faint everyday yet some do. So in those cases, a TTT can CERTAINLY not be accurate. But poor man tilt or the test (only one formal TTT) I always flunk.

but an unenlightened doctor who doesn't pay attention COULD see it as "anxiety" since that is the first and often only label thrown at women.

[Guest dionna]

first i was diagnosed with NCS and then POTS. my boyfriend was diagnosed with just NCS.

okay... on my first TTT April 13 05 i did faint after the nitroglycerin was put under my tongue. here are the results that you can actually see. S- supine/ T- tilt (of course).

------time------BP----------HR----SPO2

S----12:24----112/63----60-----100

S----12:26----121/69----70-----100

T----12:28----121/74 ----86 ----100

T ----12:30 ---99/77 -----89 ----99

T ----12:33 ---117/81 ----83 ---98

T ----12:38 ---115/90 ----97 ---99

T ----12:41 ---117/77 ----96 ---99

T ----12:46 ---117/81 ----81 ---99

T ----12:49 ---116/83 ----85 ---99

T ----12:54 ---119/87 ----90 ---98

T ----12:57 ---111/69 ----83 ---100

T ----12:58 ---118/85 ----92 ----97 --Nitro was given

T ----1:01 ----111/83 ----108 ---97

T ----1:03 ----106/65 ----115 ---98

T ----1:05 ----105/60 ----119 ---98

T ----1:08 ------37/? ------65 ----97

S ----1:09 ----102/56 ----50 ----98

S ----1:11 ----102/64 ----54 ----98

they determined that my test was positve for syncope and this is when i was diagnosed with vasovagal syncope/ NCS they said. i was put on the beta blocker propanonal for migraines this same day just after the test. no prior meds had been taken.

then later after more testing and the stress test--- which i fainted on, i was told that i have POTS. Dr. Goldstein reconfirmed it at NIH after he gave me a TTT that was negative for syncope given on October 25 05. these were the documented results that day.

-------time-------BP----------HR----- no SPO2 documented

S ----10:50 ----135/78 ----65

T ----11:02 ----135/82 ----85

T ----11:06 ----132/81 ----86

T ----11:10 ----135/84 ----81

T ----11:14 ----129/80 ----91

T ----11:18 ----125/81 ----87

T ----11:22 ----120/78 ----93

T ----11:26 ----123/81 ----95

T ----11:30 ----123/80 ----95

T ----11:34 ----116/77 ----99

T ----11:38 ----120/81 ----103

S ----11:49 ----128/78 ----76

(plus i have the results from the blood drawn at 4 minute increments on this test but i won't bore you with that).

before this test i had stopped taking all my meds 5 days prior. midodrine, florinef, prilosec, and neurotin. i had already been off propanonal for a few months. you can see that my BP was higher on this test and my HR was about the same for both. but like i said the one at NIH was a negative for syncope but he still said i have POTS.

i mentioned that i have POTS and my boyfriend has NCS. we still have very similiar experiences. i just get tired quicker and faint a lot more plus a few other things are different but as we all know even POTS patients don't experience all the same symptoms. he also didn't faint on his TTT but he still got the diagnose of NCS because of how he felt. so obviously they could still determine something of his TTT. he had to make them tilt him back down because he felt so bad but he was close to fainting. in fact he had thought he did but they said he didn't. so maybe actually seeing numbers can help you out some.

good luck to you.

dionna

[2manyfurkids]

I know what you mean about getting so used to the feeling you are going to faint that you sit or lay down before you actually do. That was what was different about the TTT. As soon as they tilted me, I started with those same feelings of nausea and felt restless because I wanted to lay down and couldn't. After the injection and I passed out, I woke up not remembering passing out in the first place and very dazed. After, a few minutes I felt "like I was coming back to life". I heard the nurse, "Are you ok?" I could nod in response. That is the way it typically happens. Usually when I lay down before fully passing out, I can't open my eyes, (my husband says my eyes twitch)but I can hear people talking and can respond by nodding. But after the adrenaline injection, I was totally out of it. I've never passed out and hid my head or anything, because I always know when it is coming and lay down. Just goes to show you, when your body is put in a position where you can't do that, things could be alot worse!

[ode_to_fantasy]

they told me that my TTT was positive, and they injected me with adrenalin as well.