POTS, postural Orthostaticc Tachycardia Syndrome.

[Appleloveme]

I have noticed recently when sitting my pulse rate is usually at 66/68, but when I stand up, it sits at 80/90. I sit down again it drops down again, to normal. In the morning more noticeable, after I halve eaten. Sometimes it will drop to 37/42. Any suggestions or remarks, thank you. I have had ventricular Ectopic diagnosed alongside palpitations recently. Ecg, holter, also have seen a Cardiologist. Do you think I should get in touch again and mention this!!

[Cookieisland]

Do you have any symptoms related to the jump? Your heart rate does increase on standing as it has to work harder. If you feel fine and been tested for it then it may just be normal for you. If you have an irregular pulse and using a smart watch, it will count the irregular beats as a much lower bpm.

My heart rate goes up to 120-150 on standing and then immediately drops to 70 when sitting down again. I haven’t been diagnosed with pots but I do have sinus tachycardia for much of the day. It used to be even higher before starting medication for it and I get dizzy standing up too quick or doing too much exercise and letting my heart rate go fast for too long. Apart from that I’m just learning to pace myself and find things that help. Hope that helps!

[MikeThePike in reply to Cookieisland]

That sounds like POTS. When did it start?

[Blearyeyed]

Are you getting these results on a Smart Watch? I was wondering, particularly for the lowest as that could be an error because it's too loose , too tight or the reading was interrupted.

I have POTS as part of my Chronic Dysautonomia conditions. I also have Sinus Node Reentrant Tachycardia, Atrial Fibrillation, Vasospasms and Vascular Migraines, my cardiac problems are mainly caused by autonomic nerve dysfunction rather than problems in my heart muscle.

Usually, for POTs to be confirmed your Heart Rate ( not BP) must either increase or decrease by 30bpm within a minute of either standing or sitting ( sometimes this is checked at 2 minutes.

If your heart rate is already very high or tachycardic , even without movement your standing heart rate needs to rise by approximately 28bpm and stay over 100bpm throughout ten minutes of standing still.

So, if your readings are accurate you would not be classed as having POTs.

In fact , if these results were taken over a minute after changing position and you are being active and have no other symptoms and increase in heart rate as you move is normal.

You heart rate and blood pressure need to increase as you stand to help maintain the blood flow in your arms and legs.

As we age , or for some people this change can be as much as 20-25 bpm and classed as normal, especially if it isn't causing any other rapid onset symptoms.

The largest changes in heart rate as you move are normally in the morning and after eating , this is because the body has rested or your heart rate and blood pressure drops to its lowest levels when you sleep or eat.

Therefore, if you suddenly get up and start moving after a while the nervous system jumps into action and speeds the heart up a bit quicker than at other times of the day to cope with a number of big changes at once.

If you have other symptoms as well like dizziness, vertigo , near fainting, light headedness and blood pooling in the hands and feet ( also POTs symptoms) sudden onset head pain, blurred vision, tremors and palpitations you could have a different type of Orthostatic Condition.

These are Orthostatic Intolerance issues.

Sometimes OI can be caused by really simple reasons like dehydration, vitamin and mineral insufficiency, moving too quickly after being still for a long time, age or hormone changes.

Sometimes Orthostatic Intolerance can be caused by big swings in blood pressure rather than heart rate.

You should check if this is happening with a blood pressure monitor rather than relying on a smart watch blood pressure measurement because these can be inaccurate.

If your blood pressure increases rapidly or decreases rapidly with certain movements as well as having higher heart rate you may have Orthostatic Hypertension, Orthostatic Hypotension or Orthostatic Sinus Tachycardia.

All of these conditions , just like POTs need to be tested properly if you are having abnormal readings on a medical grade monitor often and you are getting other symptoms , first with a Holter worn at home for a minimum of 72 hours, then if the results of the Holter show concern with a Tilt Table test to work out what sort of Orthostatic issue is happening and why it could be occurring.

Not all orthostatic and rapid changes in heart rate or blood pressure are cardiac problems , some are caused by the autonomic nervous system , but some are also possibly caused by short term , simply treated health issues , like inner ear problems and infections , salt imbalance, dehydration or vitamin and iron deficiency.

I use the self care for POTs and also require medication. Before I was diagnosed my resting heart rate was very high 80/90 and after standing it would jump to between 120/130 BPM and if I still continued to stand still ( or sit with my legs down) my heart rate would continue rising very quickly to 140-150 . When I moved it would start to come down. I would also get a sudden drop in BP on standing for 3 minutes which is another indicator POTs.

When I laid with feet up within a minute my rate would drop by 40-80 BPM.

I still have swings but the treatment can help stop it getting out of control as well as helping to reduce the resting heart rate to normal levels and stop it happening so quickly that it can cause fainting.

[Appleloveme in reply to Blearyeyed]

Thank you Blearyeyed for all the details, much appreciated, taking your time to answer. Take care.

[Cookieisland in reply to Blearyeyed]

This is such an informative reply and very helpful to me too. It almost exactly mimics what happens to me. I’ve had POTS mentioned to me quite a few times so I am going to pursue an answer to my symptoms. This forum is such a great resource. Thanks and take care both.

[happyrosie1]

you’ve already had really comprehensive and useful replies and I shall just add that the website of Blood Pressure UK, the specialist charity, might give you some useful hints and tips. They have a helpline too.

[GoodHearty]

When I first experienced AFib, I thought it was related to POTS after doing searches online, and when I mentioned it to GP, she had never heard of it and brushed it off and told me to learn to stand up properly(!).

When in A&E at least the doctors considered it but discounted it with simple table tilt tests, which is used to help diagnose POTS.

Best to get experts take a look, there is an excellent YT video by Sanjay Gupta who goes into a lot of detail explaining POTS and AFib.

Best Wishes

[Appleloveme in reply to GoodHearty]

Thank you Good Hearty that is great information. I have used Sanjay Gupta regarding my Ventricular Ectopics, he is extremely helpful. Take care.

[MikeThePike in reply to GoodHearty]

I find it disgraceful how ill informed some doctors are.

[Appleloveme in reply to MikeThePike]

Hi MikeThe Pike , I just noticed the spike in the heart rate, quite recently but have had the Ectopics, palpitations for many years. It does seem to be more relevant in the morning. Hope you are well, take care.