During Your Ttt....

[cardiactec]

During your tilt, did they give you a med injection (nitro, isopros., etc). if so, did they give you the injection while you were supine or when you were upright?

they gave me it when i was supine (and i remained supine for the majority of med testing, wasnt tilted upright), but i have heard that a lot of people have had the med injection while upright.

what's the difference btwn supine or upright med injection during tilt? can one cause more "false positives" than the other?

since they gave me the med injection while supine, do you think i should have them repeat the tilt and give me the med when i'm upright or do you think it wouldnt yield any more info/or better info about BP issues?

my tilt test was VERY positive (HR wise, BP didnt change all that much) with upright tilt, so i am assuming because it was SOOOO positive with HR, that maybe they didnt want to give the med injection while i was upright to see what the BP would do for fear that i could go into cardiac arrest (my rates were CRANKED without the med - 200+ one time) ??? any thoughts?

[Ernie]

Hi,

I think that if you HR was 200 after they gave you the injection that is why they did not raise you up. Your BP would have crashed. You don't need a repeat TTT since you have a postive diagnosis.

[cardiactec]

ernie,

my HR was 200 BEFORE they gave me the injection (this was during upright position). my BP at this time stayed okay, like 110/60. then they put me down, my HR immediately dropped to 90 and BP went to about 120/60's. then supine, the whole time, they administered the med but never put me upright while giving the med, or after giving the med.......seems like the majority of people are given the med when they are upright, not supine....

[Jacquie802]

No meds for me! I wore a helmet like thing that showed decreased blood supply to my brain. I had a positive tilt.

Jacquie

[cardiactec]

jacquie,

mine was positive without med injection also, for CRAZY HR's but nothing for BP.....even though my test was positive BEFORE ANY med injection, they i guess still decided to give the med to see how my BP would handle it - but like i have been saying, i was supine the whole time they administered the med - and nothing happened with the BP really, dropped out a little. i am just wondering why they didnt tilt me up after having administered the med.

[Jacquie802]

How long were u tilted upright with hr like that?? My HR went up to 170's and my bp dropped wayy low so the doc lowered me. This was after being tilted for 7 minutes.

[cardiactec]

i was tilted upright for 20 minutes with HR's like that (200). and pressure only dropped about 20 points.....

[Ernie]

Hi,

What was your HR chznge during the med injection?

[cardiactec]

surprisingly enough, while supine, the med injection only brought my rates up to around 145 from a supine baseline before injection of 90BPM... and my BP dropped to like 92/60s from pre-med injection of BP of around 115/60's... i expected my rates to do what they did while i was upright with med injection (go to 200) - they didnt though. i am just curious what my BP and HR would do if they had given the med to me while upright. well, perhaps i wouldnt want to see what my HR would have done - it would have been like 400 probably or can we say ASYSTOLE!! lol! hahaha! not sure how the BP would have responded.....

i emailed my cardio who performed the tilt on me and asked him why he didnt give me the med while upright, still waiting on a reply....

[deucykub]

Hi, cardiatec:

I wasn't given any meds at all during my TTT. My HR reached the 150s on upright tilt, and my blood pressure dropped to 109/39. After 25 minutes of upright tilt, my HR and BP fell to 99 and 85/49, and I got very nauseated and hot. They ended the test there. After the clinical exam, they diagnosed me with POTS and predisposition to neurally mediated syncope. Now I'm trying to figuring out what that means exactly...

[dizzygirl]

I had a med injection once during a ttt... this particular ttt.. my bp droped from like 140/over something to like 60/??

they lowered me and gave me Isoprol (sp???).. OMG.. believe you dont "want" that injection.. my experience was not a nice one.. I seriously felt like i was going to crawl out of my skin.. and i shok uncontrollable.. my HR was racing like a bat out of you know what.. they never di tell me what my hr got to on the injection.. but it was horrible..

But i was laying down when they gave me the med... but i was given the best to see my response to hyperadrengic pots i guess..or something like that..

i had drop and spike both in my HR and BP...

But i have a positive ttt with out with out meds.. and ive had 5 ttt's....

[sfrnklin]

Cardiactech,

My first TTT I was given nitro subling. and had a positive test and was put on beta blocker. Years later, my second TTT, I was given Isopril IV while upright and my test was negative, but I STILL have POTS. I don't trust the results of TTT's. My dr said lots of things can cause the results to be false positive and false negative, etc. I wouldn't repeat it, unless you just fill it is absolutely necessary. I absolutely hate TTT's. Because they are not 100% accurate all the time, I refuse to take anymore.

Sfrnklin

[Ernie]

Hi,

Your vitals changed enough even supine to confirm the diagnosis he had when you did the TTT standing that he probably did not want to risk standing you and making you faint.

[Lukkychrm42]

It does seem abnormal that they gave you the med supine, but to be honest, I'm a little surprised that they gave it to you at all. To me it seems more common for those suspected of NCS to induce fainting. It does seem more likely to cause false positives that way, although even the TTT system isn't perfect without the injection. I had the sublingual med during my first TTT when I was suspected of having NCS, but the second time was med-free.

Even though your rates were pretty wild, it seems that they'd have to tilt you for a TTT to be accurate. But I'd guess that if they know what they're doing as far as TTTs go, then they probably just wanted to keep you as safe as possible while still doing the test.

I hope you get some answers soon!!

[MomtoGiuliana]

I was not given any meds for my TTT. I had a strong positive--my hr went from 80 lying to 160 standing. I did not have much of a change in bp--but for POTS it is hr that is the indicator...

Katherine

[cardiactec]

my cardiologist wrote me back via email regarding why he didnt give me the med injection while upright, this is what he said, "The tilt issue you are talking about is using the tilt to look for

vasovagal syncope. Your heart rate was too high with tilt to give any

medications while upright. Also, syncope is not your problem so these

people have different issues".

answers THAT question! )

[Ernie]

Hi,

Thanks for sharing his answer.

think he was very considerate of your health and did not take any unnecessary risk to give you a diagnosis.

[cardiactec]

no problem ernie. but i wonder how he would determine if syncope WASNT an issue with me unless he tried to trigger that response with med injection while upright? perhaps due to the fact that i have never actually passed out (on my own, without any med injection, no Hx) that given a med injection to try and trigger a syncopal episode would probably be more of a false positive for me - since it was med induced, and not a "true" faint. there are many false positive with TTT and using meds to induce a syncopal episode in someone who has never even had a syncopal episode to begin with...........so i guess i can see where he's coming from. plus, like you said, he didnt want to put me in danger with giving me the med upright when my rates, before ANY meds, were so high.........

[Ernie]

HI,

I am no doctor but I think that with a standing HR of 200 you would have minimum have passed out and maybe have had cardiac arrest or flat lined. So is was safest not to push your body any further. You have the diagnosis and you have access to the same meds wether you have POTS or NCS or both.`

P.S. I would feel very sorry for you if your health deteriorated for another TTT to get the information that you want.

Love