Orthostatic Tachycardia

I have been experiencing othostatic tachycardia for about two years, with palpitations, after testing, bileafet Mitral valve prolapse of a moderate degree with mild to mod. MR was a diagnosis, with myxomatous changes also. I have been taking Toprol Xl daily which has helped the frequent PAC's, PVC's, and PSVT all documented with holter and event recorder.
I am now 40(female)and continue daily with symptoms upon rising of an increase in HR of 40bpm within a minute and little or no change in systolic, but an increase in diastolic pressure of at least 20mm. I had a tilt table test almost 2 years ago and the Md was concerned because my pressure went up so fast.
My concern is am I at a greater risk for a stroke due to the sudden increase in HR and diastolic on a daily basis thus far?
Should I be on a daily ASA? Any information is appreciated. Thanks.

[CCF-M.D.-RCJ]

NBCT,

Sorry to hear of your troubles.

Stroke is correlated with high blood pressure, both diastolic and systolic.  I would surmise that you would only be at higher stroke risk if your blood pressure gets into the high range, not just if your blood pressure increases from one low value to a less low value.  I am not aware of an increase in stroke risk associated with sinus tachycardia.

I cannot answer the aspirin question without further knowledge of your history, but I read nothing that would have lead me to put you on an aspirin.

The question that occured to me was "why do you have orthostatic tachycardia?"  This question may be best addressed at a center with an specialty in autonomic dysfunction.  We have one here at CCF, but other good ones exist, including at Vanderbilt University.

Good luck.