Possible POTS?

[Dasobel]

I'd like your opinion on what constitutes POTS.I've had stabbing chest pain for 2 years.The pain seems to pulse with my heartbeat.There are "high frequency" weeks,and also quiet periods when I seldom feel it.

There is a strong positional component.The pain is induced by sometimes simply standing upright,but may take longer (if at all). Standing in line, standing up for long periods at a party, etc. can usually induce it.Exercise also induces it,but only AFTER my workout, in the "cool down" period, and again, posture is key. Bending over with hands on  knees or lying supine will stop it quickly. Moving around as opposed to standing still also helps.

Only other complaint are occasional PVCs,felt as sharp pain on the ectopic beat(not the comp. beat); average one a day or so.I was checked out by my cardiologist-- stress, echo, holter, and event monitor all came back a-ok.

After lots of pulse monitoring,I noticed a correlation between my posture and heartbeat.My resting HR in the morning is around 60.Afternoon, around 70-75.But when I stand up, it goes up 10-12 beats almost at once.After 10 minutes,it MAY be up around 18-22 beats from baseline.It is during this period that I feel the pain.At higher rates, such as during exercise,I'm fine.
Questions:1)POTS is defined as HR increase +30 from baseline or over 120 bpm.Mine is less,but could it be "mild POTS" that causes the rise and pain?I'm never dizzy,just higher HR and pain.
2)My HRR after exercise seems ok;-18 after 1 min.,-48 after 2 min. But after it goes below 100 bpm,it may stay in 90s for an hour.OK?  
  

[noreaster]

hej tickertock, have been wondering about the same thing...was diagnosed with anxiety two years ago but think I have POTS since my heart rate goes up on standing up (sometimes up to 150 bpm); got used to the feeling and to what I believe are PVCs; it doesn't make me anxious anymore; I'm often tired and suffer from depression;
used to be a frequent visitor to this forum and it is here where I found out about POTs, PVCs and all the other things nobody cared to explain to me
not that it changes much, but it's just good to know ;-)

[tickertock]

The more I read on POTS, the more interesting I find this baffling medical condition. I often wonder if many diagnosed with anxiety is not actually suffering from some form of POTS.Just a thought.

[CCF-M.D.-MJM]

Hi Dasobel,

Sorry to hear about these concern.  My first thought after readying your concerns is that some of these symptoms are classic for social anxiety disorder or just an anxiety disorder.  The other point I would like to mention is that POTS is usually not associated with chest pains -- and I say this with caution after the verbal abuse I received from a poster a few weeks back in response to a post to my writing that PVCs don't usually cause pain.  



1)POTS is defined as HR increase +30 from baseline or over 120 bpm.Mine is less,but could it be "mild POTS" that causes the rise and pain?

You may be right.  The classic cases of POTS are not subtle --  standing up cases the heart rate to sore and the blood pressure to drop.  People feel lightheaded and some even collapse.  In its worst form it is a debilitating disease.  Like everything it medicine, there are continuums.  You may be on the spectrum of POTS but you do not meet strict definitions.  The best advice that I have is to accept these limitations, believe in your heart that will not harm or kill you, and move on with your life.


2)My HRR after exercise seems ok;-18 after 1 min.,-48 after 2 min. But after it goes below 100 bpm,it may stay in 90s for an hour.OK?

I would not worry about this.  It is great that you exercise and I would encourage you to keep it up!!!

Thanks for posting and good luck.

[Dasobel]

Quick addition:  I'm a 39 year old male, no other health problems. Sorry, forgot that info in my question!