Vasovagal Syncope Vs. Pots

[deeplyset]

Can anyone give me information (or point me in the right direction) on what the difference between Vasovagal Syncope and POTS is???

[flop]

Good question! Lots of doctors use terms in different ways and to mean different things, here is the way that I understand things from reading Dr Grubb's book.

Vasovagal syncope (VVS) - a blackout / faint caused by the vagal nerve being stimulated and causing a drop in blood pressure and or a slowing of the heart rate, it causes you to become unconscious briefly. Can also be called Neurocardiogenic syncope (NCS)

Postural Orthostatic Tachycardia Sundrome (POTS) - a syndrome (collection of symptoms) that includes a rise in heart rate of at least 30 beats per minute or to more than 120/min within 10 mins of standing upright. People with POTS have orthostatic intolerance - their symptoms start or are worse when they are upright. Symptoms are very varied but can include dizziness, lightheadedness, fatigue, nausea, vomiting, bloating, palpitations, chest pains, sweating too much or too little, ....I could go on (the symptoms page of the main DINET website has more information).

Some people have just VVS / NCS and have blackouts but feel well inbetween episodes. Most people with POTS don't have blackouts but feel ill when they stand up. About 30% of people with POTS have VVS / NCS as well and have blackouts as well as feeling ill on standing.

That is really over simplifying things as doctors don't yet understand exactly what POTS is or why we get it and why some people get the blackouts and others don't.

Flop

[juliegee]

Hi deeplyset-

Miss flop did a great job of explaining this. I just want to throw one more nugget out there that can further complicate this for us. Many doctors, including Dr. Peter Rowe at Johns Hopkins, also use the term Nuerally Mediated Hypotension (NMH) interchangeably with VVS and NCS.

Which do you think you have? I think I have both.

Julie

[pat57]

hi,

I have NCS. Macksmom I think NMH and NCS are the same but NCS results in faint- syncope.

I just looked at the 3 TTT tests I have at home. My BP does not rise, it drops. When given the sublingual Nitroglycerin the HR increases (from that) and in 1 minute the HR drops a minimum of 60 BPM and the BP is a total crash at 0/P. Even as the HR rises the BP drops.

[juliegee]

(quote) "Macksmom I think NMH and NCS are the same but NCS results in faint- syncope."

Hmmmm. Maybe some with NMH do not faint, but my son does. Like you, his BP is not measurable. After standing for 30 minutes (no nitroglycerin), his BP droped precipitiously from 120/80 to 40/0 on his TTT at Hopkins.

At Johns Hopkins NMH is used INSTEAD of NCS. I was told they mean the same & the terms can be used interchangeably. Obviously, there is an alternate definition out there. Flop and I just went over this in a prior post:-)

Pat, have you always had NCS? Or did you used to have POTS? I ask because my POTS was a much bigger deal when I was younger, not the NCS/NMH (whatever you call it!) seems to be a bigger deal for me.

Julie

[pat57]

no POTS here, Macksmom. Orthostatic Hypotension did show up before the NCS.