Tilt Table Testing

[Katie]

Is it possible for your to tell me the significance of these results on tilt table testing for a teenage male who has been hypertensive and tachycardic for about 15 months, even on medication?

While lying down, he was hypotensive and bradycardic. Halfway upright, all was normal. When upright, he was normal to hypotensive and tachy again, but absolutely NO symptoms such as dizziness, fainting, etc.--none.

Obviously this rules out neurocardiogenic syncope. What does this tell us about POTS (postural orthostatic tachycardia syndrome)? From what I understand, his reactions should be exactly the opposite to have POTS.

Can you offer any ideas as to what would cause this total "about face" in the blood pressure and heart rate (I realize he is dysautonomic).

Thanks for any suggestions!

[Kathy]

Dear A.J.:

For some really interesting information on the questions you pose, check out the following website:    ndrf.org

This is the National Dysautonomia Research Foundation's site. There is a wealth of information, both from people with autonomic dysfunction, as well as articles, that can answer your questions.

Good luck!

[AJ]

What can you tell me about Neurocardiogenic Syncope?  Address table tilt testing and the significance of responses such as seizure and heart pause.  Adress the helpfulness of consuming large quantities of salt and fluids. Treatments available?

[Cleveland Clinic, MD]

Hope you find some answers.

[Kathy]

Thanks; your Forum is a wonderful service and I truly appreciate the help you have afforded to us.

We are leaving for our second trip to Mayo Clinic on Monday; hopefully we will get more results this time....it's so discouraging and he has lost 37-1/2 lbs. in 3-1/2 months for no apparent reason. If interested, you can read more about "Mystery Boy" further down the forum in "Teenager Going Downhill." There are a few separate articles about him.  Docs all around the country are having me e-mail them with his information so that they can use it as a learning tool. Just hope he's going to be alright.

Have a Happy New Year and thanks again.

[Katie]

Thanks; I rather thought that might be the answer. It is a very odd situation going on.

[Cleveland Clinic, MD]

His picture does not fit neatly into any one syndrome.  It sounds like he needs to see a specialist in dysautonomia such as Dr. Blair Grubb in Toledo, Ohio or Dr. Dwayne Eckberg in Richmond, VA.