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I Have Been Experiencing Severe POTS Symptoms
Question: Hello,
I have been experiencing severe POTS symptoms so I had an echo, calcium test, and holter. The echo was normal, calcium score was 277, and holter(report is uploaded here) showed SVT, PACs, possible AF, and most concerning, a few pauses, including one of 5 seconds. Between the ER, my GP and the two cardiologists in the practice I've seen, I've heard that I have nothing to worry about, or that I have significant disease. I am going to get a cardiac stress test, a second echo, and just turned in a 3rd holter for a different period. I will be seeing an electrophysiologist but it is weeks before my appointment. I've been prescribed Eloquis because of the AFib, and told by one doctor to take a beta blocker, and by another to not take a beta blocker because of the pauses in my holter. I've been given no diagnosis and no real treatment plan and am scared and uncertain. I don't know if I have symptoms that just need to be watched, or I need to be concerned about an immediate crisis. Can you please help interpret my tests? My symptoms are intermittent POTS(tachycardia upon standing, with dizziness) and palpitations.
I have been experiencing severe POTS symptoms so I had an echo, calcium test, and holter. The echo was normal, calcium score was 277, and holter(report is uploaded here) showed SVT, PACs, possible AF, and most concerning, a few pauses, including one of 5 seconds. Between the ER, my GP and the two cardiologists in the practice I've seen, I've heard that I have nothing to worry about, or that I have significant disease. I am going to get a cardiac stress test, a second echo, and just turned in a 3rd holter for a different period. I will be seeing an electrophysiologist but it is weeks before my appointment. I've been prescribed Eloquis because of the AFib, and told by one doctor to take a beta blocker, and by another to not take a beta blocker because of the pauses in my holter. I've been given no diagnosis and no real treatment plan and am scared and uncertain. I don't know if I have symptoms that just need to be watched, or I need to be concerned about an immediate crisis. Can you please help interpret my tests? My symptoms are intermittent POTS(tachycardia upon standing, with dizziness) and palpitations.
Brief Answer:
II would explain as follows:
Detailed Answer:
Hello,
Unfortunately I couldn't open the Holter file (it seems t o be a system error!!) Could you try please to re-upload it on the site, ore come and paste on the window?
Actually beta - blockers would be and interesting option for your postural tachycardia; but first it is necessary to assure that those pauses are innocent (and happen only during the night sleep);
Your heart rate trends during the day - night period is important in determining beta - blockage strategy and daily dosage.
A head up tilt test would be helpful in identifying the degree of your orthostatic intolerance and symptomatic POTS.
I remain at your disposal for further discussions, once you re-upload the medical tests.
Kind regards,
Dr. Ilir Sharka
cardiologist
II would explain as follows:
Detailed Answer:
Hello,
Unfortunately I couldn't open the Holter file (it seems t o be a system error!!) Could you try please to re-upload it on the site, ore come and paste on the window?
Actually beta - blockers would be and interesting option for your postural tachycardia; but first it is necessary to assure that those pauses are innocent (and happen only during the night sleep);
Your heart rate trends during the day - night period is important in determining beta - blockage strategy and daily dosage.
A head up tilt test would be helpful in identifying the degree of your orthostatic intolerance and symptomatic POTS.
I remain at your disposal for further discussions, once you re-upload the medical tests.
Kind regards,
Dr. Ilir Sharka
cardiologist
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you Dr. Sharka,
I have attached the Holter report.
I have attached the Holter report.
Brief Answer:
Opinion as follows:
Detailed Answer:
Hello again!
I reviewed your uploaded Holter reports. It seems that there are many episodes of supraventricular arrhythmia (tachycardia and atrial fibrillation/flutter). It would be necessary exploring the thyroid and pulmonary function (if there is a direct impact). Though pauses were detected, it was difficult to clarify the exact duration of them due to artefacts
I would suggest continuing on beta blocker therapy and Holter monitoring follow up to direct ongoing therapy.
Hope to have been helpful!
Kind regards,
Dr. Iliri
Opinion as follows:
Detailed Answer:
Hello again!
I reviewed your uploaded Holter reports. It seems that there are many episodes of supraventricular arrhythmia (tachycardia and atrial fibrillation/flutter). It would be necessary exploring the thyroid and pulmonary function (if there is a direct impact). Though pauses were detected, it was difficult to clarify the exact duration of them due to artefacts
I would suggest continuing on beta blocker therapy and Holter monitoring follow up to direct ongoing therapy.
Hope to have been helpful!
Kind regards,
Dr. Iliri
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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