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Preparing for Your Initial POTS Assessment – The Active Standing Test
The Test
This Active Stand Test is performed by our nurse, and checks how your heart rate and blood pressure respond when you move from lying down to standing.
You will be asked to lie flat and relax for 5-10 minutes, before standing upright or leaning against a wall for 10 minutes. Your blood pressure and heart rate readings are recorded every minute. You will also be asked what symptoms you experience during the test.
It is best done in the morning, but can be done any time of day if you cannot arrive in the morning.
The test is virtually diagnostic of POTS if abnormal, but sometimes a test is normal. Be assured that a normal test does not rule out POTS as a possible diagnosis, as people with POTS have “good days” and “bad days”.
The day before
Avoid the following:
- Alcohol
- Nicotine
- Caffeine (including coffee, tea, cola, energy drinks, and caffeine tablets)
- Unusually heavy or intense exercise
- Extra salt or electrolyte loading (unless your doctor has told you to do this)
Drink water normally, but do not deliberately “preload” with large amounts of water or electrolyte drinks.
On the day of the test
Please attend fasting if this is safe for you. If you need to eat, have only a light meal and avoid eating within 2–3 hours of the test.
You may drink plain water.
Avoid:
- Caffeine
- Nicotine
- Alcohol
- Heavy meals
- Compression socks, compression leggings, abdominal binders, corsets, or shapewear
Wear loose, comfortable clothing like shorts or loose pants that be rolled up, so that your lower legs can be monitored for changes.
Medications
Some medications can affect your heart rate or blood pressure and may make the test less accurate.
Please bring a full list of your medications and supplements. If your doctor has asked you to hold a medication, bring it with you so you can take it after the test.
Do not stop any medication unless your doctor or Dr Jeremy Yang has specifically told you to.
Medicines that may affect the test include:
- Heart-rate–lowering medicines, such as beta blockers (metoprolol, propranolol, bisoprolol) or ivabradine
- Blood pressure medication
- POTS medicines such as midodrine, fludrocortisone, or desmopressin
- ADHD stimulant medication such as dexametamine, Vyvanse, Ritalin and Concerta
- Some antidepressants, such as amitriptyline, duloxetine or venlafaxine
Important safety note
Do not skip medicines for your heart, blood pressure, diabetes, seizures, mental health, thyroid, hormones, pregnancy-related care, or any other important condition unless your doctor has clearly told you to.
If you are unsure, take your medications as usual and tell the testing team what you took.