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POTS and blood pressure
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Debsbears posted:
I was dx'd with POTS 2 yrs ago when I began having fainting spells. I also had a severely compressed spinal cord which required a 7 cervical fusion 1 yr ago - which seemed to help in stopping the fainting spells.

Well, the spells are back to the point of passing out - just recently I had a 48hr heart monitor results should be in 7 to 10 days.

I was told to get a heart monitor to keep an eye on things - I am to use it sitting and standing - What is the best way to use it meaning: do I sit for 10 mins test then immediatly stand and test again or do I have to wait? My Drs were not clear on that do you know? Thanks for your help.Deb 56yrs old.
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James Beckerman, MD, FACC responded:
It can be helpful when wearing a monitor to try to recreate those situations that cause the most symptoms for you - like getting up quickly from a sitting position for example. That might be what your doc had in mind, but you might give a call to ask to be sure. Take care.
 
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Debsbears replied to James Beckerman, MD, FACC's response:
Thank you very much I wore the heart monitor for the 48hrs but didn't have a spell. I did have a few events where my heart went up to 154 beats a minute.

After re-reading my original post I was trying to ask about a blood pressure monitor. I was told to get one those as well and keep track of my pressure sitting and standing.

But they didn't explain how to do that. Does one stand first take a reading and sit and wait a few minutes and take a reading or the other way around?
 
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cardiostarusa1 responded:
Hi Deb:

"My Drs were not clear on that"

"But they didn't explain how to do that."

All the more reason/important to consult with them (as they are fully-obligated to advise the patient) first and foremost.

Important points about Postural Orthostatic Tachycardia Syndrome (POTS) -

As reported:

POTS is defined as a clinically significant increase in heart rate (anywhere from occurring immediately or to within 10-30 minutes) upon standing from a lying down or sitting position.

The length/duration of time patients diagnosed with POTS can comfortably stand varies wdely from one individual to another.

POTS often generates a temporary rise in blood pressure (BP) immediately upon standing due to rapid acceleration of the heart rate.

POTS patients often have a measurably low standing pulse pressure (that is, difference between systolic and diastolic, normal resting pulse pressure is 40 mmHg, give or take a bit), which may/can be an indicator of blood pooling (collecting).

Some patients with POTS have a damaged regulatory system that may/can result in paradoxical wild swings in BP from under 50 mmHg to over 200 mmHg. Complexly, POTS can be a low and high BP pressure problem combined.

During a Tilt Table Test, some POTS patients have large drops in BP and pass out (syncope, temporary loss of consciousness, also includes fainting), while other patients have only relatively shallow/small drops in BP, or no at all.

75% of POTS patients are female with a genetic tendency to be passed down from mother to daughter.

Best of luck down the road of life.

Take care,

CardioStar*

WebMD community member (8/99)




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Be well-informed

Patient resources

Dysautonomia Information Network

http://www.dinet.org/index.htm

Family Doctor

Blood Pressure Monitoring at Home

http://familydoctor.org/128.xml

Mayo Clinic

Get the most out of home blood pressure monitoring

http://www.mayoclinic.com/health/high-blood-pressure/HI00016

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BP begins to rise as one awakens, peaks in the late afternoon or evening, and then drops off gradually, becoming the lowest when sleeping. Normal resting blood BP in adults is under 120/80 with 115/75 or 110/70 considered as being optimal/ideal.

Taking BP measurements when at rest/relaxed will help yield more consistent readings. If one has had a peaceful night's sleep, then measurements are best taken as soon as one awakes in the morning, as at this time of the day, the body will be at its lowest functioning levels, both physically and mentally, and therefore the factors that affect BP will be minimized. One should try to take the BP at the same time(s) every day.

PLUS, there was a study, in which University of Virginia researchers tested 100 individuals two times, once while they perched on a doctor's table, feet dangling, and then again as they sat in a chair with both feet resting on the floor and their back and arms supported.

Systolic BP, the top number, dropped by 13 points on average while sitting in the chair. Why's this? According to study author Melly Turner, RN, if your arm, back, and legs are not supported, then you're exerting energy while being tested.

The prestigious American Heart Association has been recommending the chair method, but harried medical staff often don't employ it. Sit quietly in a proper chair for 5 minutes before having the BP checked, and be sure the arm being used rests on a flat surface.

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Quote!


"Be a questioning patient. TALK to your DOCTOR and ASK QUESTIONS. Studies show that patients who ask the most questions, and are most assertive, get the best results. Be vigilant and speak up!"

- Charles Inlander, People's Medical Society


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It's your future......be there.

. .

WebMD/WebMD forums DOES NOT provide medical advice, diagnosis, or treatment.
 
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Debsbears replied to cardiostarusa1's response:
CStar thank you very much - another question if I may

Is POTS something we were born with? or can it just show up? I was dx'd with it maybe around 2 yrs ago. No one even suggested testing for it until I was in the EP's office, when he tested my bp in the various positions. I also have been recently dx'd with LVDD and CHF could these cause the POTS?

It just just 2 weeks ago I had the passing out spell that made my PCP tell me to get the bp monitor. After I get the results from the heart monitor I will know more as to what Dr to see.

Again thank you very much for your help you aways give in depth explanations which are much appreciated.
 
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Debsbears replied to cardiostarusa1's response:
Update to my last post.

CStar what you said makes sense to me

sitting bp 121/85 60 heart rate

after standing 5 mins: bp 105/71 80 heart rate
 
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cardiostarusa1 replied to Debsbears's response:
You're welcome and thanks for the update.

"Is POTS something we were born with? or can it just show up?"


It can be either.

From Dysautonomia Information Network

Pertinent snippets

POTS can be categorized as primary, meaning it is idiopathic and not associated with other diseases, or secondary, meaning it is associated with a known disease or disorder......

People generally develop POTS after becoming sick with a virus, giving birth, or being exposed to great bodily stressors (i.e. surgery, trauma or chemotherapy). Some people have had POTS their entire lives. Teenagers sometimes develop the disorder during the years of rapid growth, and 75-80% of them can look forward to being asymptomatic when they reach adulthood.

"I also have been recently dx'd with LVDD and CHF could these cause the POTS?"

It may/could, or be contributing factors.

Take good care,

CardioStar*




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It's your future......be there.
 
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Debsbears replied to cardiostarusa1's response:
Thank you very much for your help.
 
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cardiostarusa1 replied to Debsbears's response:
You're welcome.

Take extra-good care,

CardioStar*



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It's your future......be there.


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