Discussions By Condition: I cannot get a diagnosis.

positive tilt table test

Posted In: I cannot get a diagnosis. 10 Replies
  • Posted By: pamelasmc
  • December 11, 2008
  • 00:40 AM

I just had a TTT that was positive. My main symptom is heart racing upon standing, but I also have many other symptoms that fit POTS. My cardiologist doesn't think it is POTS in spite of all this, because my blood pressure didn't drastically change during the test. He wants me to go for more tests. I AM SO FRUSTRATED ! This has been an ongoing struggle for twenty years. I just want to feel good again. I am not sure what to do, any suggestions?

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  • Try here: http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1513525 There is a section in this article that is titled "What are the Results of a Tilt Table Test?" It may be of help to you.
    aquila 1263 Replies
    • December 11, 2008
    • 02:57 PM
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  • Thanks, I'll go check it out.
    pamelasmc 82 Replies
    • December 12, 2008
    • 02:41 AM
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  • Regarding your postural orthostatic tachycardia syndrome,if you will list more of your symptoms,perhaps I can help.:)
    richard wayne2b 1232 Replies
    • December 12, 2008
    • 03:40 PM
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  • I forgot a very important fact:in POTS the blood pressure often but not always drops.
    richard wayne2b 1232 Replies
    • December 12, 2008
    • 03:45 PM
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  • Thanks richard !Symptoms are:History of passing out beginning at age 6, then 8, then 14, 21, 28,34, last time at 44 at the end of a treadmill stress test on the uphill part, blacked out and fell to knees.History of heart symptoms, all documented by my gp or cardiologist. Sometimes tachy, sometimes brady, sometimes skipped ...earliest memory was around 9 years old.History of weirdness....can't take hot baths, sit in hot tub, ride g force carnival rides, can't tolerate heat, can't take otc meds without bad reactions, sensitive to body lotions, any strong smells, cleaning products, etc...Can't tolerate alcohol, caffeine, any sort of stimulant...heart goes crazy, up to 240 bpm.Can't have novacaine at dentist, heart races from epenephrine in it.At age 34 went to er with heart racing 220 beats per minute for about 30 minutes. They said anxiety, gave valium and sent me home. Gp gave usual tests of event monitor, stress test, etc all normal. Ended up at "shrink" who put me on paxil, xanax, and beta blocker. Felt ok for awhile but heart palps continued on and off for years...september this year (age 48) started weaning off of paxil due to alot of weight gain. Within 3 days i started to notice alot of skipped beats with chest pain. Overnight in hospital for the same tests as above with "normal" results. Except for thyroid, 6.97. Sent to endocrinologist who re-did blood work and thyroid numbers now normal. Back to cardiologist for event monitor and tilt table test. Event monitor results normal but positive ttt. Upon being raised on the table, my heart rate went from 68 to 132 in 1 minute, then stayed around 110 until i was given nytro, passed out in 2 minutes. However, my bp did not drop enormously.To sum up, my whole life from earliest memory has been cycles of the folowing: (my suspicion is that i have always had pots and by being put on ssri, xanax and bb my symptoms were masked) resting heart rate 62, stand up goes to 130.Feel faint oftenpainfully cold hands and feet (and butt)extreme fatigueonly feel ""normal" lying downsome anxiety when standing, subsides when lying downbrain fogfeeling stuffed after small meal and for hours afterwardarm muscles feel weak and can't do any overhead workcan't stand from a squatting position , or bend over from the waist because of faintnessexercise intolerance, especially anything uphill my current cardiologist says he can't classify me as pots because of my blood pressure response. I have read that the blood pressure doesn't always crash and pots is based more on heart rate changes. I was actually relieved to have a positive ttt thinking that after so many years i would have an answer ...but now the cardiologist wants me to go to rush presbyterian in chicago for more tests. I just want to feel better... Sorry this is so lengthy, but after years i've accumulated alot of info.Thanks for any insightpamela
    pamelasmc 82 Replies
    • December 12, 2008
    • 06:42 PM
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  • richard???
    pamelasmc 82 Replies
    • December 14, 2008
    • 03:06 AM
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  • Hi,again.I,too, suspect that you have had POTS for a long time but without the drop in blood pressure.Ask the doctors about that.:)
    richard wayne2b 1232 Replies
    • December 14, 2008
    • 04:08 PM
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  • Perhaps you have a more general diagnosis called''dysautonomia.''
    richard wayne2b 1232 Replies
    • December 14, 2008
    • 04:52 PM
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  • Anyone else??
    pamelasmc 82 Replies
    • December 15, 2008
    • 11:11 PM
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  • Okay, based upon your description, you very likely have a demonstrated allergy to esters. Esterification is very commonly used in the manufacture of lotions, perfumes, particular cleaning solutions, some medications and yes, in novocaine analogs like Procaine, which most dentists favor. Ester allergies are not all that common and go largely undiagnosed because of lack of recognition in the common factor of esterification in commercial products that the patient may mention coming into contact with, that do not initially seem to bear any connection. In the case of the Procaine, it's more likely that you are responding to the ester and not the epinephrine, rarely the preservatives can also cause allergic reaction as well. Based upon your description, I don't believe this is POTTS for a number of reasons and dysautonomia has some salient physical features expressed in most cases that you don't make mention of, so I doubt it's the case. I'm presuming that since you've been formally evaluated by several specialists, that a work-up for pheochromocytoma was included among the diagnostics. I don't see it mentioned in your list, but I may have overlooked it. Still, I'd be surprised if it hasn't already been considered and ruled out. Please indicate where this test was performed and the outcome. Best regards, J Cottle, MD
    JCottleMD 580 Replies
    • December 16, 2008
    • 00:53 AM
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