I’m not sure if this is the right place to ask but at the end of May I had an episode of vasovagal syncope and was diagnosed with pernicious anemia, which I was then medicated for. I continued to have fainting episodes and was then diagnosed with orthostatic hypotension. My heart rate rises by 50bpm upon standing and gradually drops back down, when I am in the shower etc it raises to 160/170bpm. My GP has since put me on a calcium channel blocker for the heart rate..
Does this sound like the correct approach? For context I am 24-years old and was seemingly healthy before the first fainting episode (apparently not). I had a standard ECG which raised no concerns however the increase of bpm and decrease of blood pressure occurs when standing, when hot etc
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Connie2372
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So have the diagnosed you with POTS? That's Postural Orthostatic Tachycardia Syndrome.
Are they also treating your B12 with injections ?
How did they diagnose you from a Holter alone or did they give you a tilt table test?
Medication wise it all depends.
Which Calcium Channel blocker did they prescribe if you don't mind me asking.
Calcium channel blockers are one of the medications used for orthostatic Tachycardia or orthostatic blood pressure problems and they can work well , but if you're particular orthostatic Tachycardia is acute ( short term) and could have been caused , in part, by Vitamin B 12 deficiency that needs to be properly treated as well .
I know my cardiac problems, POTs and Dysautonomia did not improve very much until my functional B12 Deficiency was diagnosed and finally treated with injections.
You are usually given Self Care advice too.
To slow your movements and wait before walking from sitting to standing , and vice versa.
Drinking water just before getting up or sitting down can also reduce the heart rate swing and chance if fainting.
To choose physical activities that involve less sudden movement up and down of the head and upper body .
To drink more water each day and increase salt intake by a small amount.
To wear compression leggings and sometimes t-shirts to improve blood flow and stop blood pooling in your hands and feet.
To eat five smaller lighter meals portions a day rather than three big ones.
Unfortunately, there isn't a POTs or Dysautonomia HU forum but there are a few of us with vasovagal heart conditions and POTs or Orthostatic issues on the BHF forum , so hopefully you will get more answers.
It's also worth looking up the POTs UK website which is full of advice about symptoms, self care tips and medications used ( they change depending on what causes the symptoms for each individual).
Hey, no they haven’t diagnosed me with POTs but from reading up myself it does sound similar to my symptoms. They diagnosed me with hypotension following 2x episodes of fainting whilst at the GP practice. I haven’t had a holter nor a tilt table test - I just shared with them my concerns re my heart rate from my Apple Watch recordings and they prescribed Diltiazem. The ECG I had was a few minutes long whilst lying down.
I had 6 loading doses of b12 injections and have been put on 10-weekly moving forward. I am also taking folic acid for 3 months.
It certainly seems like your GP is more aware of what help to give with orthostatic Tachycardia than many are.Just seen how you go with the medication , and perhaps have a discussion with your GP about POTs when you next see them.
I know this is an older post, but I would suggest you try to see an autonomic specialist. A NASA Lean Test could help too.
Some of what you have described seems a little at odds, although I am not a doctor of course.
For example, calcium channel blockers lower blood pressure (that’s their main use), so prescribing a calcium channel blocker to someone with orthostatic hypotension seems unusual. The usual medication to control tachycardia is a beta blocker.
PoTS UK is a good source for information on PoTS, although it’s possible that you have another form of orthostatic intolerance (or something else altogether).
Taking hot showers will cause vasodilation too… try cooler or just use the bath until things settle down…folate is better than folic acid…may find sodium bicarbonate helpful because it increases BP and reduces calcium in serum.. at the same time…calcium channel blockers reduce the action of calcium which tightens muscles..magnesium relaxes arteries which cause even more drop in BP… magnesium is a natural counter to calcium… are you taking too much magnesium?…are you sweating at night? Electrolytes replacement may be part of your issue… hope you find relief and get things back under control real soon.
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Fast heart rate?
Cardiologist pushing for beta blockers but my heart rate is slow anyway.
fainting/ syncope and heart condition 
Heart rate
Low heart rate
