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othostatic tachycardia

I am scheduled for a tilt table test next week. I have bileaflet MVP of a mod. degree and mild to mod. MR. I have been on Toprol XL for six months for daily PAC's, PVC's, PSVT all documented with moniters and even during tests. The Toprol has not been effective, even with dose increases. My lying and sitting heart rate is around 65bpm with a sudden acceleration to over 100(recorded highest 126) in less than a minute upon standing. This happens with every change in position, every hour, of every day,causing lightheadedness, and a surge of palpitations with chest pain at times. I feel constant fatigue. My question is with these symptoms and confirmation from a tilt test, would a doctor be able to order short term disability until different meds are tried? I am a nurse on a very busy unit, and have been effected by this for almost a year. I have an excellent reputation at my job, but am considering asking for a leave, but I want a paid leave of abscense. I see doctors everyday at work but choose not to share my personal concerns with them, otherwise I would ask their opinions. Thank you for any information you may have.
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Avatar universal
Hi Jean, If your holter showed no arrythmias and your cardio has ruled out POTS that should help to reassure you what you are feeling is not causing any harm to your heart. The irregular beats I mentioned were frequent PAC's that had long pauses, juctional rhythm, and PVC's, all of which cause no harm, but are annoying when felt.Again, I hope you have tried some of the ways I have used to alleviate any unneccesary fear. I spoke with a co-worker yesterday who I have known for ten years, but only get to see her if I float to her unit. We were talking about the stresses of nursing and joked about career changes. I mentioned to her how I had been feeling the past year. I was shocked when she told me she has MVP and has experienced the same symptoms for 18 years. She was equally suprised to hear how I felt, because she said whenever I pass you, or see you at a meeting, you always seem to be in good spirits. We shared our common stories of fear, anxiety, MD appointments, and most importantly the ways we use to overcome the anxious feelings. Remember Jean you are not alone. Keep trying everyday to decrease your fears and I promise you will feel in control soon. Good Luck and Take Care.
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Avatar universal
When you say irregular beats do you mean something more than just sinus tach? My holter showed no arrythmias at all and my cardio said no to POTS but I am just scaring myself every time I stand. I never get dizzy is that a main symptom?
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Avatar universal
Hi Jean, I had the tilt table test on Tuesday, and the doctor who performed it gave a definite diagnosis of POTS. My heartrate lying flat was around 80. As soon as the table went upright my heartrate increased to the 120's within the first minute. I felt lightheaded as usual and it showed my Bp dropped. The palpitations and irregular beats started(as I knew they would)and were seen by the MD on the EKG. He asked me during the test if I was feeling the irregular beats and I answered everyone of them. At the end of the test he was very understanding about the way I have been feeling and said he would discuss treatment options with my cardio. She called me that evening and we discussed everything from increasing salt to different meds.She was reassuring and knowledgable and I respect her opinion. I am going to try what works best for me. If your cardio is thinking about POTS as a diagnosis for your symptoms, go to this web site for more information www.ndrf.org it will help answer questions and ease your mind. Keep thinking positive thoughts! Attitude is a little thing that can make a big difference! Best Wishes.
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Avatar universal
Hi Jean, I had the tilt table test on Tuesday, and the doctor who performed it gave a definite diagnosis of POTS. My heartrate lying flat was around 80. As soon as the table went upright my heartrate increased to the 120's within the first minute. I felt lightheaded as usual and it showed my Bp dropped. The palpitations and irregular beats started(as I knew they would)and were seen by the MD on the EKG. He asked me during the test if I was feeling the irregular beats and I answered everyone of them. At the end of the test he was very understanding about the way I have been feeling and said he would discuss treatment options with my cardio. She called me that evening and we discussed everything from increasing salt to different meds.She was reassuring and knowledgable and I respect her opinion. I am going to try what works best for me. If your cardio is thinking about POTS as a diagnosis for your symptoms, go to this web site for more information www.ndrf.org it will help answer questions and ease your mind. Keep thinking positive thoughts! Attitude is a little thing that can make a big difference! Best Wishes.
Helpful - 0
Avatar universal
Hi again,
I wanted to see how you did with the tilt test. I also wanted your opinion. I wore a 24 hr holter monitor that showed while standing my heart rate was 109,125 even 150 and then another time while walking up the stairs only 77, and once I thought it was so fast it was only 92.  Can you tell me with othostatic tach. would my heart be fast every time I walked or stood? I am trying to see if it is my nerves doing it or if this could be what I have also. My cardiologist says its just from the MVP and anxiety. Are there other symptoms with POTS? Thanks so much Jean
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Avatar universal
I have heard of cardiophobia and truly believe that is what I have but can not find any Dr's who ever heard of it. It is driving me crazy I am always thinking about my heart and feeling it to check if it is fast. I am like NBCT used to be I am so scared to go out alone or to be in my house alone or even on some days to walk because I dont want to cause the heart to race. I really need help and reassurance that this is not a true heart problem and not coming from the MVP but I cant find an understanding DR. I feel if I could just find someone to explain it all to me I would be OK. Thanks Jean
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Avatar universal
Dear Hankstar, Very well stated! A cardiologist can never fully understand how someone is feeling unless he or she experiences the same thing. This forum has people who have many different symptoms,but the one found common in all of us is fear. Jean, begin thinking positive thoughts, force yourself not to take your pulse and enjoy life. Take one day at a time, you will feel more in control once your fear diminishes(remember I've been there) Keep me posted.Good Luck and Take Care!
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Avatar universal
Hi Jean, I want to share with you ways I have learned to deal with the constant worry of every heartbeat. I used to always take my pulse when I felt the increases,sometimes twenty times a day. I became tired of counting and soon realized nothing ever happened to me if I did know the rate or not. I can feel the increases daily, but only check my pulse once a week now. I bought a CD player headset and listen to my favorite music to relax me at night if the palpitations decide to hang around for  awhile. I drink 48-72oz of water everyday. I developed a fear of going out alone wondering how I would feel. I then realized if something was going to happen or my heart would fail, I could not do CPR on myself anyway! So I do my errands and shop weekly without fear! My attitude is the only thing in control now. I never call out of work, even on my worst days, because it distracts my mind from my heart. I would like to take a short leave only to find the most effective medicine with the least side effects. I hope some of this helps you. Good Luck and Take Care!
Helpful - 0
Avatar universal
Dear Jean, Hi, Let me start by saying, I completely understand how you are thinking and feeling, but I want to reassure you that these changes in heart rates we experience are life annoying not life threatening. I too have MVP and every symptom related to Mitral valve prolapse syndrome. When the palpitations, lightheadedness, and fatigue began, I found myself taking my pulse frequently. It took me almost two months until I made an appointment with the doctor, because I knew his respose would be, you are obviously just stressed out, and when he did say those words, I responded, you obviously don't know me.( I had not been to his office in 12 years) My cardiologist is very reassuring, and this site offers many helpfull comments from others who feel the same, advice I have used to stop allowing my symptoms to cause anxiety. My concern about taking a short leave from work, is because I am finding myself becoming less tolerant of trying patients, tons of paperwork, and hours on my feet(sometimes the entire 8 hour shift without a lunch break) due to the way I feel and meds I have been on. I used to do 12 hour
shifts and be able to laugh and joke through the worst of days.
HOWEVER, I think positive thoughts daily and live each day to the fullest(thanks to MLS Poly and others on this forum) Best of Luck to you.
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Avatar universal
Thanks for the kind words. It helps to hear the heart rate so fast is not life threatening. I always think something horrible is about to happen to me because of these feeling I get. I havent figured out how to just walk and not be so tuned in to what my heart is doing. How do you do it with 8 hours on your feet all day? Is your heart constantly fast through the day while standing or does it eventually slow down? My cardiologist is not very helpful and I think that is why I am so scared because I dont understand why the heart beats so fast just from walking or standing. How will I know if it is ever a dangerous thing? I dont black out and most of the time I only know its so fast because I am always taking my pulse.  Thanks so much Jean
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Avatar universal
Hi, I get the same thing when I stand my heart goes over 100 but mine is not every time. Some days I am fine, so you get this every day? Also is it so fast that it is pounding or do you know its fast because you take your pulse and see its fast? Sometimes with me it is fast and I dont even feel it unless I take my pulse then I realize it is over 100 and then I get scared and want to sit down. Is there any danger in walking around with a heart rate this high? I get very scared when it happens to me and find myself sitting around most of the day. I was also told I have MVP and that this is common with this condition but I dont know how true that is. Do you have MVP also? Thanks I look foward to your reply. Jean
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Avatar universal
Dear NBCT,
I suppose it is possible but the determination of disability would depend on the specific guidelines of your state/insurance company and the doctors judgement of your status. I suspect it would be an unusual situation and you would need some type of documentation to demonstrate that you really are unable to perform your duties due to this condition.  Best wishes.  I hope you get to feeling better
Helpful - 0

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