cardiactec Posted February 11, 2007 Report Share Posted February 11, 2007 my PCP just gave me some print offs of recertification for primary care docs. one of the things they have to know for recertification (my PCP is a resident) is pots. i was shocked that they had to know it! i'm glad they do but surprised that they do, as pots has been so underrecognized! (if that is even a word?? lol) .........anyway, this is what the paper says, and i quote, dr blair grubb copyright march 2006........"the POTS is CHARACTERIZED by SYMPTOMS of ORTHOSTATIC INTOLERANCE AND AN EXCEEDINGLY HIGH HEART RATE - BUT OFTEN NOT ORTHOSTATIC HYPOTENSION - ON FIRST STANDING UP. symptoms can include fatigue, nausea, palps, headache, near syncope, and syncope. THE PRINCIPLE FEATURE OF POTS IS ORTHOSTATIC INTOLERANCE, DEFINED AS THE PROVOCATION OF SYMPTOMS AFTER ASSUMING UPRIGHT POSTURE THAT ARE RELIVED BY RECUMBENCE."so, in the post on "what is the difference between pots and OI", i think this sums it up. sounds like OI is the PROVOCATION OF SYMPTOMS".........................so my question is, can you have POTS and NOT have symptoms?? because according to grubb it sounds like the actual clinical criteria for being diagnosed with pots is that you A. have symptoms of OI and B. have a high heart rate when upright. .......this is interesting in that, some people who answered my poll on "what is your HR's without meds when standing" polled that their heart rates DID NOT exceed 100BPM, which is NOT considered "an exceedingly high heart rate" as blair explains, but i'm sure these people are symptomatic..................sounds like there is major discrepancy in what actually defines this condition. can you have an EXCEEDINGLY HIGH HEART RATE when upright as grubb says and not have symptoms but yet still have pots? can you have a SLOW heart rate (under 100) and be very symptomatic and still have POTS??confusing?? Quote Link to comment Share on other sites More sharing options...
corina Posted February 11, 2007 Report Share Posted February 11, 2007 i think it is all so complicated. during my ttt my hr went up to above 180 (lying was about 60 or 70, my bp dropped more than 20 or 30 points and still i didn't faint. i felt a complete wreck and my body was screaming to lay down but i did not faint. i can't understand why (not).although i've learned so much from this website and from all you here on this forum, i still have questions. i do wish i could cross the ocean and ask dr grubb to explain my situation to me.corina Quote Link to comment Share on other sites More sharing options...
cardiactec Posted February 11, 2007 Author Report Share Posted February 11, 2007 hey corina,lol, dont worry, if i ever venture out to see grubb, he's only about 9 hours away from me, so i'll save you the trip across the ocean and ask him for you!! )i know what you mean. my heart rate supine was 95 and immediately became 190-200 standing. my BP dropped 25 points. i only felt some nausea and some generalized weakness but nothing that made me scream to go supine again, so symptom-wise, it varies for me. mostly i feel OKAY. i have been diagnosed with pots mainly off of my surge in HR from supine to stand, not symptoms - though at the time diagnosed, i didnt really have many symptoms except for nausea. now it varies, sometimes i feel good, sometimes i feel a little sick. rarely do i feel like major crapola. another thing, since we're on the subject of diagnoses and "Criteria to meet", isnt hypotension defined as a drop of 20 points of more in BP from supine to stand? i have never been diagnosed with hypotension but my pressure from supine goes from 120 to 80's standing....my doc said i didnt have hypotension at the time...... Quote Link to comment Share on other sites More sharing options...
morgan617 Posted February 11, 2007 Report Share Posted February 11, 2007 I wouldn't think you'd have to be above 100. If your recumbent heart rate is 60 and when you stand up, it jumps to 90, that's not normal. A normal heart rate adjustment is about 10 beats and that's only for a few seconds. I'm not sure where they came up with >30 beats or whatever.If you are not symptomatic, then I'd just be happy not to be, but i guess i would view it like a pre diabetic thing. When a pregnant woman develops gestational diabetes, she has to deal with it during the pregnancy. Typically, they are NOT symptomatic, the test just shows them to have high blood sugar counts. After the pregnancy, they return to normal....however, studies have shown that these women are much more likely to develop diabetes at some point down the road.I would guess it might be the same with POTS. You may not be symptomatic for awhile, but if it continues, at some point you will be. That would just be my guess though. But I would expect anyone who jumps or drops up to 30 or more beats per minute, is going to feel something.....When I was younger, I always got "head rushes" when I stood up.....they cleared up quickly then...and look at me now... Quote Link to comment Share on other sites More sharing options...
MomtoGiuliana Posted February 11, 2007 Report Share Posted February 11, 2007 I would guess that yes you can have POTS with the only symptom being the hr change on standing. Many days that is my only symptom. Other days I have accompanying symptoms--for me, I become most symptomatic in the days before my period (typical for POTS patients.) But my hr does not usually go above 120 standing--these days. But, I would think each patient has their own tolerance and ability to adjust?Katherine Quote Link to comment Share on other sites More sharing options...
DancingLight Posted February 11, 2007 Report Share Posted February 11, 2007 Corina,Did your bp stay stable??? That is probably why you didn't faint and why your diagnosis is POTS not NMH or another category (or more than one diagnosis). Just a thought?????Emily Quote Link to comment Share on other sites More sharing options...
yogini Posted February 12, 2007 Report Share Posted February 12, 2007 You can have POTS and haqve your HR below 100. My baseline is in the 70s. My POTS had improved last year to the point where my HR was below 105 most of the time last year on a very low dose of beta blocker...although for the past 2 months my HR has gone up again. I did have POTS symptoms even when my HR was controlled, mostly fatigue and exercise intolerance. I do think that doctors take me less seriously - they don't even seem to be worried when I have an HR of 125, although it is hard for me to function at this level. Quote Link to comment Share on other sites More sharing options...
Guest dionna Posted February 12, 2007 Report Share Posted February 12, 2007 wow... i think i am confused some... i have the symptoms and the fast heart rate... very often when i stand... actually almost every time i stand even if it is just for a few minutes. i thought all pots patients were like that. i see that i am wrong! i am glad some of you are better off! that is excellent!!!dionna Quote Link to comment Share on other sites More sharing options...
sfrnklin Posted February 12, 2007 Report Share Posted February 12, 2007 I have POTS and I see Dr. Grubb. I have high HR's upon standing and a significant drop in BP according to him but I DO NOT faint. I do have some crummy symptoms but a lot less since he did an ablation on me. Mostly just some fatigue if I work too much, heat/cold intolerance, exercise intolerance, head aches, stomach aches, and slow bowels. The SOB, heart palpitations, chest pain, and anxiety went away after the ablation.Susan Quote Link to comment Share on other sites More sharing options...
deucykub Posted February 12, 2007 Report Share Posted February 12, 2007 Morgan, I think the 30+ beats was determined to separate POTS from deconditioning. From what I've read, typically the heart rate will increase more than the typical 10 - 15 bpm on standing due to deconditioning, but if the increase is greater than 30 bpm, that points to illness.I think..... By the time we all start to feel better... we should each receive an honorary medical degree. Don't ya think? Quote Link to comment Share on other sites More sharing options...
mom4cem Posted February 12, 2007 Report Share Posted February 12, 2007 As far as heart rates, before beta's I could jump up to over 120,,still do on occasion, but now on beta's it usually is 70's sitting and 80's standing, but if it goes to the 90's sitting or standing, I feel lousy, just as I had when it was in the 100's-120's etc. So guessing though rates can be controlled the other symptoms may not always back off too. Quote Link to comment Share on other sites More sharing options...
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