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Neurology (Expert Forum)
What are the clinical diagnostic criteria for POTS?
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What are the clinical diagnostic criteria for POTS?
by hfollett, Aug 17, 2004 12:00AM
I have a HR increase of 45 bpm when going from supine position to standing, accompanied by dizziness, fatigue, brain fog, sinus pain, low grade fevers, facial flushing, and loss of balance. I am being told by local physicians that without a drop in BP that I cannot be diagnosed with POTS, which is contrary to all of the information I've read on the internet. Without the diagnosis I don't feel like my medical attention is as aggressive as it should be.
Who is right? Can you provide me with text or an online link to a "medical bible" that I can use as information to disprove them?
Thank you so much for your help!
Who is right? Can you provide me with text or an online link to a "medical bible" that I can use as information to disprove them?
Thank you so much for your help!
Doctor's Answer
by CCF-Neuro-M.D.-CS, Aug 23, 2004 12:00AM
Postural orthostatic tachycardia syndrome is a diagnosis established when a patient has symptoms of orthostasis (light headed/ dizzy sensation) associated with a increase in heart rate and a small change in blood pressure. One formal defintion for the change in heart rate I found is an increase by 28 beats per minute. Usually when we stand our blood pressure decreases slightly. The heart rate then increases to compensate, and then the blood pressure increases and the system returns to normal. If you are questioning the diagnosis already given, perhaps a second opinion at an academic institution would be reasonable. Good luck.
My blood pressure raises after the first few minutes I stand up because my heart rate increases upon rising,(this can be misleading) but after standing still for a few minutes it slowly drops.
If you have not had a tilt test, then insist on one.