Tilt testing in POTS 

I can tell you exactly why most Tilt Table Tests came back negative for me. When I am sat down and my heart rate was say 60, I can stand up and it'll easily jump to 100+ - when you're being rushed around a hospital, standing up, standing to get onto the table, and perhaps even just general nerves, my HR started high, so the jump on the tilt test wasn't as high as it should have been - stand test is worse - the reality is most tilt tests are rushed, you're not left for a period of time just lying in a dark room. I was prone for barely 20 seconds before they titled me up.

Just some feedback....Sound volume is too low.

I just had a negative tilt table test and am very grateful for this video. Several years ago, I developed severe orthostatic intolerance and was diagnosed with ME/CFS at Mayo. Unfortunately, they didn't even consider POTS, and they treated me as if my problems were psychosomatic. Even now, knowing that ME, POTS, fibro, and EDS are all very real, physical problems, I struggle with self-doubt, and it's hard to keep making appointments with doctors when I'm constantly afraid of being written off as a hypochondriac. Thank you for believing your patients.

We all need a physician like you in every specialty!

“I listen carefully to the patient” so important and so rare. Thank you for spreading information about this debilitating and misunderstood condition.

I had a TTT in 2008 after I had my son when I began fainting. It was a miserable experience. All I got out of it was “you have POTS” after I collapsed on the table. I’ve never gotten better. I live exhausted. That’s the main symptom these days. It’s is debilitating and I lost my career as a realtor. I do take desmopressin regularly and it helps, but the brain fog in the morning makes me useless. Not to mention the unbearable fatigue. I can’t earn income; yet can’t qualify for disability. So unfair to POTS patients. Thank you for all the amazing work you do. You are brilliant.

I just received and negative tilt table test from Mayo and was told that PoTS is ruled out for me. My bpm every morning spikes by well over 40 when I get out of bed. I was nervous in the hospital so my bpm was already high and did not spike sufficiently for a positive result, despite the fact that I was incredibly symptomatic. This made me lose hope again until I saw this video. Thank you for this very affirming and validating video, it will help me keep going and keep advocating for my symptoms so they are not written off as anxiety. Everyone deserves a doctor like you!!

Thank you for this info. You look very handsome with your full beard. 🙂

This video 🙌🏼 so fed up of being told this is anxiety!

Just wanted to thank you for the “How to stop STV attack”. It was like a miracle. Thank you 🙏🏻 Subscribed and added to favorites.

I can’t tell you how much these videos are helping me . If only I’d been able to see something like this 35 years ago , my life would have been so much easier , calmer, happier . Thankyou from the bottom of my unpredictable heart . ❤️

There's so much about heart problems I don't know. As a Cardiologist, do you discuss these issues with your patients? My Cardiologist certainly doesn't! I would know very little if it wasn't for you and your gift of these videos. Thank you, Dr. Gupta and God bless you. I hope you understand how appreciative we are.

This video is so encouraging. I had a negative table test also but most other symptoms present. I started into chronic fatigue around puberty and in my 20's was diagnosed with anxiety and sinus tachycardia. I was traditionally a low blood pressure patient and always faint if I sit up while getting blood drawn. I became alcohol and caffeine intolerant over the next 2 decades and had frequent episodes of tachycardia. 4 years ago I had a highly stressful event that landed me in the hospital with chronic tachycardia and high blood pressure. I lost my appetite and 20 pounds over 3 months. Out of that came diagnosis of fibromyalgia, sleep apnea, all chamber tachycardia and AFib. I am currently exercise intolerant. Worst of all was the brain fog, fatigue and body reactions to carbs and sugar. Fortunately, even though my doctor says I don't "technically" have POTS, I am undergoing a long-range slow ramp-up exercise program that involves rowing and floor exercises. I feel like I'm in slow deterioration. The exercises are killer but I'm told after month 3 I'll start to feel better. Here's hoping....

This is very affirming, thank you. I am 67 and on my 8th year of dysautonomia, hEDS, MCAS, SIBO, GERD, LPR, arrythmia, CCI and have just seen my 40th doctor. I failed my TTT so am not formally diagnosed with POTS even though I've got all the symptoms. I'm glad that nonetheless, I have found treatments for myself that have greatly improved my life, all of which are not covered by USA insurance or considered standard of care.

I had a tilt test that showed “modest drop in BP” but not enough to meet diagnostic criteria. They didn’t even explain WHY i had the test. I just looked up PoTS because of a TikTok video and realized I’ve been tested. Meanwhile, when it gets worse, they freak out and test me for a heart attack..again. These symptoms are only problematic when I’m standing: grocery shopping, dishes, etc. As soon as I sit? Or lie down? The immediately begin to lessen. Things that have made me feel the best? IV fluids.

OMG, this is what I got and all the doctors wanted to prescribe me anti depression. I was very frustrated so I have acupuncture and alternative treatment, I feeling better now.

My previous cardiologist suspected POTS and did a10min standing test. For one, she was asking me questions the entire time I was supposed to be resting. It was also cold in her office (heat is a big trigger) and it was a good symptom day. So, on the basis of one test, they concluded no POTS and never re-tested or did a TTT. They just kept telling me I had sinus tachycardia and to maybe exercise more, and was I sure I wasn't anxious?

Thank you, I really needed this video after an awful appointment with a cardiologist who even admitted to not having expertise in POTS

I'm very interested to come across this video. I have a TTT on 20th September and already have diagnoses of fibromyalgia and ME/CFS and have the corresponding symptoms - palpitations, spikes in heart rate, brain fog etc and have instances of pain in heart area moving into left arm and jaw. I also become very shaky and dizzy and need to sit down. It can be quite debilitating so I hope the TTT results can be read sympathetically in the way you explain.

I was always wondering Why I feel so bad in the morning. After breakfast my heart gose insane. Now I drink 2 glass of water before breakfast I hope it helps in time. Thx

Thank you for the video, really appreciate you sharing your knowledge on this topic 😊.

I have symptoms of PoTS and had a positive active stand test. However, I had a tilt table test today that came back negative. They now no longer think it is a cardiology problem. So they have reffered me back to the GP. I feel so deflated and defeated and feel like it is all in my head. I'm now wheelchair bound and can rarely walk unless it's a few steps. I still struggle even then. I'm going to fail my college course because I'm not allowed to do the practical exam in a wheelchair. I don't know what to do anymore. 😔

this is me lol every symptom..i have appointment to see you dr gupta i hope it isnt cancelled again..bless you.i watched all your very first vids..and have been through hell last 4 or 5 years

I thank God for Doctors like you! 🙏🏼 Thank you for believing us and seeing us. 🤗 I cried when I was diagnosed too. Living with invisible ilnesseses is exhausting in itself, but having to convince your Doctor of the validity of your symptoms is even more exhausting.

Dr. Gupta, could orthostatic hypotension alone cause POTS or POTS symptoms ie tachycardia upon standing +30bpm?

Can we stop calling it the TILT TABLE TEST? Everyone who’s done the test know full well it’s called the TORTURE TABLE TEST.

I had my TTT today, and upon being tilted from laying flat to fully upright, my heart rate jumped up a whole extra 46 bpm. However, that elevated HR was only sustained for 2-3 minutes before it started coming back down, so my TTT was negative and I was told they couldn't diagnose me with anything.

Doctor how can we different with the patient with health Anxiety ? Anxiety makes pulse rate go up naturally. How can we really diffenciate between POTS and anxiety ????

Hello , can you tell me how you treat your patients with pots?

I died twice during that test. Awful awful test (kind of medieval 😅). I was diagnosed with POTS, NCS, 3rd degree Av Block, Fluttering and put on a Pacemaker soon after the test. This showed how stressful the test was for my heart.. but at least I was diagnosed.. before that everything was "normal"

Please is there anyway I can speak to you i have been having pvc's since I was 16 and I'm 27 now and it's become very sympathetic to a point my heart slows down and I have sporadic palpitations to having TIA's , my body gets weak and heavy I'm fatigue all the time when I exercise I feel really bad and my heart beats really fast and I can't sleep because my heart pounds .. I feel like in drifting away and I try to fall asleep ... I have been given calcium channel blockers and it made things worst... I'm so tired I need help .. how do I get in direct contact t with you ...😞😣

I've had a negative TTT but I showed autonomic dysfunction on my QSART a year ago. 3 years ago I had a Takotsubo event. Blood work just showed I have active EBV. I'm 60yro and all but bed bound. It's so awful not having any help or understanding. Being dismissed or made to feel crazy. I have all of the other symptoms of dysautonomia besides HR & BP issues.

very interesting thank you!

Mine went from about 100 bpm (already anxious) to 152 bpm. My BP stayed roughly the same, so poor heart was racing to keep things steady I guess. I’m only like it during periods of worry and stress, and during these phases I am most affected after eating and when I’m hot. I have type 1 Osteoegenesis Imperfecta and I’m hyper mobile. It’s bad at the moment after a week of bedrest in hospital with what was a suspected fractured vertebra but turns out to just be a new disc bulge. Now I’m more worried about standing and if I’ll ever get over this orthostatic intolerance.

Thanks for educating on POTs diagnosis ☕️

Sir plzz make a video on chest pain examination ....whether itz angina,gastric or lung disorder...

I had a tilt table test about 15 years ago and was diagnosed with POTS after years of a diagnosis of just "tachycardia" and possible "inappropriate sinus tachycardia". Sometimes I still feel like it is something more than POTS. My heart rate is high when my beta blocker is due (every 12 hours) no matter my posture. Then I take the beta blocker and 15 minutes later I'm good to go. If I have not taken my meds yet, there is no way I can exercise or walk around much because my heart rate would be out of control, but I could just sit around or stand in place and it wouldn't be as bad. Could that still be POTS (a little physical activity =out of control heart rate). I also have extreme palpatations after eating decent size meals or when I have acid reflux. I have found your videos on that issues very helpful. I discovered Prilosec helps the heart palpitations by helping the stomach. On another note, I am pregnant and have more heart palpitations and days where my tachycardia is worse than normal. I'm concerned it will continue to get worse.

Can you have an autonomic nervous dysfunction if you have a negative autonomic tests but a positive tilt table test?

Sound very low

Thank you. I have been diagnosed (eventually) with post polio syndrome. Symptoms include POTS-like symptoms (similar to CFS and fibromyalgia I believe) and I hope to get treatment. We know about long covid, will we see a pandemic of post covid syndrome in 10, 20 years time if the virus gets into the brain?

Dr Gupta do you do telehealth? I would love to have my records sent to you and have one. I’m in Memphis TN area.

I can’t thank you enough for all this very valuable information Dr., your patients are extremely lucky to have such an understanding doctor like you.

You HeLp us a lot. Thank you- Charo. I am having palpitations and trying to know what causing it

when going for tilt table test should i come off bets blocker for it

After watching this and many of your other videos, I’m still confused on one thing: if your HR goes up 30+ on standing, does it have to be maintained for minutes or can some PoTS patients HR go up and almost immediately start coming down? Thanks.

thanks for sharing. Are there any foods that can help unclog arteries ?

Thank you that you try to treat patients,not test results.Its wise to try out treatment and see if a patient improves on it. I didnt need a passive tilt test because my poor mans tilt was very abnormal, but I know patients who are symptomatic and the passive tilt table test was negative. I wish there were more Drs like you.

So, I have an interesting situation w/ tilt table tests. I've had a history of fainting...not necesarily postural related, but my cardio said let's do a tilt table test. The simple/poor man version was normal. But, I agreed to the tilt table and It was the WORST test ever. I was okay until they decided to use a medication in the IV to 'provoke' my heart. I felt nauseous right away, then I fainted. They said it was a positive result. I looked it up and thought...but these are not my symptoms. Fast forward to a few yrs later...still having episodes of fainting. New cardio wants to repeat tilt table test. I was reluctant - the last one was awful. He assured me he would be there for the test and I would be fine. I did it and I was until they injected the medication. Again, felt nauseous and fainted. I woke up shaking, incoherent, with my shook doctor hovering over me talking, but I couldn't hear him. I guess they gave me a medicine to get my heart rate up. It dropped extremely low and I went into a junctional rhythm. To this day, I swear, I think my heart stopped during that test. There is no record of my test at my doctor ofc or at the hospital. The doctor would never tell me in detail what happened and acted very distant after that incident. He was supposed to discuss the results with my mother afterwards, but just left the hospital. I have two positive tilt table tests and literally none of the symptoms of POTS, besides fainting unrelated to posture. Super confusing. I will NEVER get that test again. I remember feeling a void when I fainted. Normally, I faint and I wake up and feel like no time has passed. This was different. t felt like I was conscious of being unconscious. It still freaks me out thinking about it.

💕💕💕 I'm taking 88 MCG. Levothyroxine every morning. On my last visit to the doctor's office, I was asked (when he was headed out the door) if I've ever thought about stopping this medication because my latest test shows my thyroid is normal. Question: Under the circumstances, could this medication be the cause of my heart palpitations at night? 💕💕💕

Thank you for this. I really needed to watch this. My 15yo sister is seeing many specialists. One of her specialists is a Cardiologist that specializes in Dysautonomia. She passed all the tests he has done. So he diagnosed her as being dizzy and fatigue. It is frustrating because he put her on blood pressure medicine 1 1/2 pills 4x a day, she is on another medication to help retain salt, he also put her on salt pills 2 pills 3x a day, her neurologist put her on migraine medication and a medication to help her be able to eat, and her pulmonologist put her on adrenal for her narcolepsy 2. Its frustrating because all this medication she is on and he has her diagnosis as dizzy and fatigue. I don’t know anyone her age needing so much medication for being dizzy. Her symptoms are low blood pressure, hard time breathing, hands always shake badly, migraines, blood pooling, blacks out when she stands up, heart feels like it pounds out of her chest, heart rate goes sky high, always exhausted, can’t walk long before needing a wheel chair (she use to be on the travel and all stars softball teams), very fatigue, bad memory loss she can’t remember anything, eating makes her feel sick, the list goes on and on. Her lab result just came back last night that she has the gene for Narcolepsy 1. In my heart I believe she has POTS and is not just dizzy I wish the Cardiologist would see it. The school is not going to take a dizzy person seriously.

Can't you turn the volume up

Some Pots can be brought on my other illnesses, once it may be found, Pots can be helped. My daughter had the full test, her 02 flow dropped 40% to her brain. She does have Ehler Danlos which cannot be healed, which interferes with her autonomic system. Has MCAS as well. She is allergic to beta blockers. Her doctor does pediatrics. Took forever to find the right doctor. Pediatricians blamed it everything on stress lol I’m more stressed than she is. Most doctors think it’s a heart issue. Medication also can cause a POTs reaction. Video is informative, spot on with symptoms. I’m glad some who have a neg pots tests are still able to be treated. Question is there a difference between POTs and Dysautonomia? I find the parasympathetic and sympathetic systems are malfunctioning. We can’t find anyone who treats EDS. Geneticist does his best with increasing vitamin mineral therapy. Salt is a must for my daughter to help increase blood volume. She faints, even scared her Pots Doc of 3 yrs.

I have thought for a while that I may have POTS and I literally have every single "secondary" symptom, including formal diagnoses of fibromyalgia, chronic fatigue syndrome, and hypermobility. I watched a video on how the tilt table test is administered and I am terrified to do it because I think I will just pass out or throw up.

Stress ,hormonal imbalance so so right ....I don’t know I have POTS or no ...but symptoms are the same...my life is just disturbed...I tired Ivabradine and my doc has been telling it’s anxiety and has suggested propranolol

Great video. I am being investigated for symptoms which could be POTS - fast heart rate, gut problems, headache, fatigue, tinnitus, shaky, unable to stand for more than a few minutes. It has been going on for a few months and I feel terrible most of the time. Can't go out, very poor quality of life. N.E.T.s have been ruled out by an endocrinologist. I am taking 40mg propranolol but no great difference experienced. My G.P. thinks it's anxiety. A physiotherapist specialising in head injuries is going to do a tilt test. I had a concussion a couple of years ago and I see her for whiplash treatment. I live in NW England. Where do you think I should be going from here in terms of getting a diagnosis and treatment? Thanks.

I had an abnormal tilt at Cleveland Clinic. Supposed to stand for 45 minutes. Made it to 39 and BP dropped drastically. From 125/90 to 70/58! As soon as they laid me down I was fine. They told me I DON'T have POTS, but rather, Reflex Vasovagal Syncope. What's the difference? All this is post covid. A year and a half later and too many docs to count, I'm still suffering. No one listens because they never find anything and labs are always normal. I've lost my life. From athlete and first responder to couch potato. 😪

I can’t get my head around my results of my TTT that I have had today it states that my blood pressure was increased, and my heart rate went up but apparently not enough for 30 bpm. I have a phone call with you in October but they say it’s not consistent with a diagnosis of POTS. My blood pressure didn’t drop but increased. I am made to feel crazy! Does blood pressure stay high through out that’s what I can’t understand. I don’t want to waste your time by you calling me if this is all in my head. It would of been more helpful if you could of written because I am now distressed. The TTT results response is confusing as the numbers are different. The hospital letter said if there’s no change they give you a GTN spray they didn’t give me it so I thought they must of picked POTS up looks like it’s not.

I was diagnosed with Hyperadrenergic POTS in July via a poor man’s tilt table test. I’ve been on Corlanor and metoprolol since then, and have had a great response. I was referred to Stanford to do an official TTT. How long should I discontinue my medication before the test?

Feeling validated. Thank you, as I had a positive active standing test and 30yrs later, still have the same symptoms + had a negative tilt test and my neurologist told me I no longer had POTS.??? Very frustrating

sanjay , I recently experienced miscarriage due to PREECLAMPSIA. My BLood Pressure is high . Could you make a video on this please

Since 2018 (age 21) I have had day fatigue (needing at least 1 nap per day), heart palpitations upon standing daily even worse after eating or drinking sugar or carbs, a hard time sleeping at night most days... body weakness, feelings of extreme hot and extreme cold. This has been for years, went to the ER for over 40 short syncopal episodes. They did an orthostatic blood pressure and they said it was indicative of POTs. Just did my Tilt table test today and it was negative because my heart beat 22 upon being lifted by starting my heart rate was higher than normal for me and I was not relaxed because they were asking me 100 questions. It feels so frustrating because I feel like I'm wrong or don't know what I'm talking about. I see my pcp tomorrow so we'll see how it goes.

Thank you so much for the videos. Super super informative. I hope this finds you well. If you ever get a moment, just wanted to hear any thoughts on my wifes poor man tilt table results. Not asking any diagnosis, just thoughts and opinions. Lying down BP 129 - 78 - Pulse 59 Stand up 3 minutes - BP 138- 97 - Pulse 95 5 minutes - BP 111- 86 - Pulse 109 10 minutes - BP 112 - 83 - Pulse 127 Based on her results, in making a guess. Id say she has both. They said if pulse goes up and not much change in BP, its Pots. If the BP drops and pulse goes up then thats Orthostatic Hypotension. But the confusing part is they say the symptoms of Orthostatic only lasts a few minutes. Her symptoms have lasted 3 months. It looks like at the 10 minute mark her diastolic starting to get closer to normal but her pulse continued to rise. Any feedback is appreciated. thanks

Mine came back negative. Went up to CC and they said I have POTS/Dysautonomia and sent me on my way. Came across a cardiologist, he listened to me. Listened to my heart and said it was hard to hear my MVP but it’s there and diagnosed me with hyper adrenaline. Put on a new beta blocker- huge difference in symptoms, much better life. What is your experience with MVPS/Hyper POTS/ Hyper Adrenaline? And genetic. All my boys have varying symptoms.

Thank you for this! I have my tilt table tomorrow. I appreciate your videos and education so much. 🙏🏻

Hello Doc. Can i ask, i do workout and do cardio. My normal heart rate is about 65. After eating sweet thing like chocolate, cookies and so on my HR gets pumped to about 90. Im not diabetic.

You sound like a very Good Doctor 🤝💞 Thank you for sharing & caring Doctor God bless you 🙏

My area doesn’t have access to tilt table testing, so I have just been diagnosed with IST (heart rate between 108-120 at rest at all times, even asleep). Heart rate does jump +25 to +40 when I stand up. Electrophysiologist saw me once and added Ivabradine to my Diltiazem and sent me on my way. I would be so curious to see if it is actually POTS.

Doctor Sanjay, if a patient's pulse shoots up by 40 when gets up standing but soon after the pulse starts to go down, is that POTS ? Thank you doctor

I wish you were my Dr. I have FSHD and POTS. I feel horrible all the time.

I have important question! I have had ECG done multiple times in my life. It was always good. Last time my doctor fricked out because readings were wrong. I completely forgot to tell him I had breast augmentation done! Didn’t think it would be important. Can silicone breast implants affect readings?

I had a positive tilt table test. At 14 minutes, my heart rate went up to 118 and my blood pressure down to 68/54. I got lightheaded and couldn't breathe, they put the table back. My quality of life was terrible. It was a good day if I felt well enough to drive to the grocery store. I also had 38% PVCs. On a 48hr monitor I had 78k PVCs. I had an ablation in 2015 and it completely changed my life. I am forever grateful.

Getting my tilt test today, ive watched for years after having PVCs and after 4 years my Dr. Is relatively certain i have dysautonomia. Idk why but it feels good to know it's not in your head and it's real

Dr i would like to ask..i had my ESP plus abaltion due to svt 2 days ago..ive been experiencing some minimal chest pains is this normal..and i also have bruises on my thigh right now..though they said its normal but sometimes i cant help to worry...hope you can reply dr..thnk you

Thank you Dr

I have 2 different doctors wanting me to get a ttt even though I'm diagnosed and being treated for pots. One just wants it on my record just in case like you mentioned. The other wants to somehow prove that new symptoms of double vision and muscle weakness are related to pots. They aren't even trying to rule other things out.

Thank you so much for all that you do! Your videos helped me more than being in the hospital with 2 cardiologist working with me. I was wondering if you are familiar with Dr Jason Fung. All about fasting responsibly and eating the full fats. Good animal fats. Thank you.

I was diagnosed with hypertrophic pachymeningitis possibly related to my lupus. I have seen 4 different neurological specialists. Two looked over my MRAs and MRIs with me. One even said out loud “wow, that’s not subtle” and said he wasn’t sure what it was. So it was a long road and lots of pain and misery. Which brings me to POTs. Even though my MRIs cleared up and my brain was supposedly normal I continued to have head pain and pressure, dizziness, nausea, tinnitus (sometimes pulsative), and head pain often worse on standing. For a year I had episodes of passing out. One EEG said it was possible seizures, but the 3 day EEG was negative. Once when I passed out I broke my ankle so badly I had to have surgery/hardware. I couldn’t get answers about the passing out but it has been a year since I last passed out. I had a cardiologist who was going to do a tilt test but I lost my insurance then she moved out of state. Being tired of Drs who think I’m crazy I just let it go. I still see my rheum and primary care but I know I need to find a new cardiologist again. Not sure about POTs as a diagnosis or if it’s possible the pachymeningitis is causing lingering issues. I rarely comment but always enjoy learning more.

Looking forward to it! 🙏

Hi, I have been diagnosed with right atrial re entrant tachycardia. When I have an episode I am able to lay down, hold my breath and make it stop. I don't want the ablation they recommended. I have started to have more episodes and am wondering if I should start taking magnesium, calcium and potassium to help with this. Do you agree?

Why do I remember this differently from last year or the year before when I was looking at this and I had to do a dizzy spells and I was looking at something that was going out for my child now we’re just talking about whether or not a heart rate goes up that was part of it but there was always a dizzy spell there I’m not hearing confusing

Hi doc, I wd like you to do a video explaining the difference between n benefits of each of theses tests viz CT Angiography, traditional coronary angiography and PET scan.. which is the best to determine the blockages and overall heart condition

I have all the symptoms, but I think mine get worse as the day goes on. Maybe because I take my time getting going?

I need your help. Negative pots syndrome tilt table test. Sob and pacs upon standing. Have to spend some days in bed. Desperate at this point. They want an ablation and I said no

@York Cardiology Any videos for brugada patterns ??

Thank you

I started passing out after menopause. I had a positive tilt table test and a beta blocker has helped.

Super useful information for providers and patients alike

What medication do you use to treat this? Would Bystolic work?

Merry Christmas Sanjay and thanks for all your efforts.

I am a drmyself enjoy all ur videos which are apt

My cardiologist has finally confirmed my Hyperadrenergic POTS. However he likes to remind me at every visit how unusual it is for a person of my age, 48, to have developed the condition. 🤔

I had the Passive Tilt Table at Mayo Rochester 7/20 & my Neuro (who had Residency here @ Mayo) believes that sometimes “Mild” POTS can often go undetected. Terribly Frustrating!!!

Dysautonomia is pots ? My tilt was positive.

Great info thank you very much! I have a question, if my hr goes up 120-135 upon standing, but no other symptoms and all the tests are normal what would that be? 🤔

In my 30 years of searching...I've had to stop. Negative TTT, they said they couldn't finish the autonomic testing because of heart rate and rhythm issues ( over 5,000 pvcs daily as per holter monitor) mornings suck the most....by night time I also get high blood pressure...raising my arms can make my hr go from 73-150 in minutes...same as heat and humidity. Eating too big of a meal or sugar/ carbs can give me worse palpitations and bradycardia and tachycardia. Even laying position can change my HR. Winter sucks....I'm too cold...but I also have sweating/ flushing issues.... summertime sucks. ....after 30 years of being told I'm mental...I've given up on drs. It's just sad...how many others out there are suffering daily too :-( Drs are often disappointed I'm not overweight an am very active...i live on a farm...so they can't blame it on that lol 🤣 I'm 4' 11" and 93 lbs....

Can an echos show acute pericarditis

I missed the Live! Hopefully next time!

I too had a PA that said it sounds like you have POTS and I cried because the MD said it wasn’t that, she didn’t listen to me. When I met with the PA I cried because I finally had someone listen to me. She has ordered a TTT and also recommends for me to wear compression stockings because I feel as though my veins on the back of my legs are narrowing and can be uncomfortable.

I would like to know if you ever tried thiamine.

Are you genetically related to Dr. Sanjay Gupta of cnn?