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Bp Changes


lil_kt
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I'M CONFUSED!!

Does your Bp have to change when standing to have POTS??? I just seen my local Doctor & he said my Bp must change & my cardiologist says it doesn't. My cardiologist diagnosed me last month with POTS. i'm confused. On the TTT my heart rate increased by 70bpm on standing & i went very light headed.

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Putting on my fake doctor's jacket and basing my response on my experience and the explanations on DINET:

"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."

On the other hand, Neurocardiogenic Syncope is characterizeddrops in blood pressure.

Unfortunately, some people have both.

Lois

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KT,

This is a common misconception among people, even doctors. As Lois said, the hr must rise 30bpm or more to be diagnosed with POTS. But there doesn't have to be a change in blood pressure. A drop in blood pressure happens with Neurocardiogenic Syncope.

I'm sorry you're getting conflicting information from your doctors. That makes understanding all of this so hard!

Rachel

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Hi,

the others are all correct, and it is true that many doctors have their own ideas of what the BP should do in POTS. My own cardiologist (who made my POTS diagnosis) has said that now my BP doesn't drop on TTT it can't be POTS causing my symptoms! (Luckily I know that he is wrong). Other doctors will say that if your BP does drop then it can't be POTS - they are also wrong! - So confusing!!!

Essentially the diagnosis of POTS is all based on what yout HR does when you stand upright - it should increase by at least 30 beats per minute, or increase to 120/min on standing. There is no mention of BP in the official description of POTS. Some people have BPs that go up, others BPs drop and some stay the same - they can all be diagnosed with POTS if the speeding up of the heart rate on standing is there.

I hope that hasn't confused you!

Flop

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I saw an endocrinologist while in the hospital in June, and even though I wasn't in for my POTS, he made me do orthostatics and then he'd argue that my BP wasn't dropping on standing, which I know, and because of this he didn't seem to understand why I'm on ProAmatine. I tried to explain what my pattern was (BP goes UP until standing for a while (like 20-30 minutes) when it plummets, and that my bp might be extremely low at other times, like when sitting or lying down. I wasn't looking for answers from him with regards to my POTS, but he was definitely convinced that as a doctor, he automatically knew everything about health and i was just a stupid patient. Well, that's what it seemed like anyway.

As you see, there are those whose BP goes down, those whose goes up, and those whose stays the same. A "normal" person's usually goes up a tad, but as for me, I just say it fluctuates. Hopefully you can rely on your cardiologist to treat you instead of delegating anything POTSwise to your other doctor. But Maybe the next time you do see your local doc, you can bring some literature that explains about POTS- that way he'll know for next time.

Good luck with everything, and welcome to the confusing world that is dysautonomia!

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