Recently, I did a tilt table test to know whether I have POTS. Please suggest.

Question

Hi doctor,

I had a tilt table test recently. The interpretation was normal. I had a rest time of ten minutes to relax before having a tilt. My resting heart rate was 80 beats per minute before doing the test. My heart rate got raised to 126 beats per minute during the tilt. At home, I had a resting heart rate of 65 beats per minute and on the blood pressure monitor, it was 57 beats per minute in the morning. Does the heart rate change often? My heart rate was above 100 beats per minute after thirty minutes of tilt and the blood pressure was 180 mm Hg after the tilt. Do I need to discuss this with my cardiologist?

Answer 1

Hi,

Welcome to icliniq.com.

A tilt table test (TTT) is usually done to diagnose vasovagal syncope and postural drop in blood pressure. In vasovagal syncope, when the heart rate decreases or when the blood pressure drops, both lead to dizziness and syncope (transient loss of consciousness). Normally in an hour, heart rate rises slightly while standing and in lying posture, and the blood pressure drops a little. But in vagal syncope, when the heart rate drops and the blood pressure decreases excessively. In your case, the heart rate is raised a bit. It is a normal phenomenon and it can be increased due to anxiety. The increase in blood pressure is unusual. It can be increased due to stress or it can be false reading as tension in the body can give a false reading of blood pressure. Please mention the reason for doing TTT.

Answer 2

Hi,

Welcome back to icliniq.com.

Yes, this is POTS (postural orthostatic tachycardia syndrome). It is caused due to dehydration, autonomic dysfunction, deconditioning of the heart due to chronic sedentary lifestyle, overactivity of the sympathetic nervous system, in patients with autoimmune disease or a viral infection. Treatment depends on the cause. Do exercise on a recumbent bike, rowing machine, or do swimming. Increase your blood volume by drinking three liters per day and liberalizing salt intake by ingesting 5 to 10 g of sodium per day. Avoiding taking large and heavy metals, alcohol, and heat exposure. Wear compression stocking up to the top of thighs. Sleep in bed with an elevation of head and perform physical counter maneuvers such as leg crossing and squatting. Behavioral and cognitive therapy can be used to obtain long-term control of symptoms. POTS is not a life-threatening condition and can be managed easily. Sometimes it can be cured and sometimes it is managed.