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967168 tn?1477584489

Tilt test?

For a dx of NCS (Neurocardiogenic Syncope) are there the same parameters with other ANS issues such as an excessive rise or fall as in bp/hr with PoTS and OI? If so, is it? >30 points like with PoTs? <20points like with OI?

Also, for proper diagnosis, does that include when there is minimal increase/decrease during the 20 min standing time or does that include when they give the med like Nitro to increase symptoms?  I've tried to find this answer and can't anywhere.

Here's my TTT results; which I've questioned -
BP 126/79 HR 77 - Start
BP 129/87 HR 101 - 20 min
BP 137/71 HR 109 Nitroglycerin given By minute #4 after Nitro was given, the patient had a syncopal event with no palpable pulse
BP 97/48 HR 78 - supine state

Findings: Profound Sinus Bradycardia; Classic symptoms of neurocardiogenic syncope with cardioinhibitory and vasodepressor responses (NCS & OI)

My questions are related to why I was dx with NCS when my bp stayed the same during the 20 minutes, but I wasn't dx with PoTS even though my HR went up 32 pts because there are different reasons for syncope.

I finally found out I was dx with HoCM back in August 2009 and just wasn't told. Patients with HCM/HOCM would react this way to Nitro and that would be an expected outcome; however my dr's said they had no clue why I reacted the way I did but that was days before I had a cardiac cath that dx the HOCM.

I called Mayo Clinic here in Fl to see one of the heart specialists so I can get a 2nd opinion, what questions should I ask about NCS/OI so I can make sure to ask when I go.
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875426 tn?1325528416
Well bradycardia, last I knew, was at least under 60 and none of the figures you posted showed that kind of heart rate, but did show they couldn't find a pulse at all at one point.  I think getting your results in the greatest detail they have on record and having it reviewed by another doctor wouldn't be a bad idea.  I believe you can opt out of the medicinal portion of the tilt table test.  I fainted after the nitro part myself and my diagnosis came out of the test as P.O.T.S., but they didn't document any time where they were unable to feel a pulse on me.

In case you would like to read up on NCS, Medhelp offers links with material:
http://www.medhelp.org/health_pages/Neurological-Disorders/Further-Reading-on-Dysautonomia/show/696?cid=196
Helpful - 0
967168 tn?1477584489
does anyone know what normal tilt table test protocol is or where i can find the info?

Is a 20 minute tilt table test sufficient?  do they always give something like nitro if you don't faint?
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