POTS Tilt Table Test (TTT) - Power Over POTS

The TILT TABLE TEST (TTT), also known as the HEAD-Up-TILT TEST (HUTT), is considered to be the “Gold Standard” (most reliable) test for diagnosing POTS. It utilizes a special table that can be gradually tilted head-end up. The test compares pulse and blood pressure when tilted upright compared to measurements during lying down prior to tilting. During tilting one is unable to squeeze one’s leg muscles, simulating the venous pooling in the lower body that occurs among individuals with POTS when standing upright. When tilted upright some with POTS experience their usual symptoms like headaches, dizziness, blurred vision and flushing. Ideally, the test is best performed in the morning and mid-menstrual cycle in females.

An increase in heart rate of greater than 40 bpm (beats per minute) in teenagers and adolescents (ages 12-19) or a rise greater than 30 bpm in adults or pulse rise equal to or greater than 120 bpm with a negligible fall in blood pressure during a gradual passive tilt (without weight-bearing) is considered a positive test for POTS.

If positive, within 10 minutes the autonomic nervous system kicks-in to speed up the heart rate and make up for the fall in cardiac output of blood to the brain. Tachycardia (rapid heart rate) is the body’s attempt to restore that all-important blood flow to the brain. Diminished blood flow to the brain is responsible for the majority of POTS-associated symptoms.

Interpretation of the TTT results should be clear cut. Requirements for a diagnosis of POTS: include:

Tilted pulse rate rise of greater than 30 or 40 beats/min,
Tilted heart rate exceeding 120 beats/minute
No significant fall in blood pressure during tilting
History of significant associated POTS symptoms
Exclusion of other medical conditions

If a significant drop in blood pressure occurs, with or without symptoms similar to those of POTS, then the diagnosis is postural hypotension (low blood pressure when standing), not POTS! Postural hypotension requires a completely different medical evaluation and therapeutic approach.

POWER over POTS by Scheldon Kress, M.D. provides an easy test (Easy Screening Head-Up Test) that anyone can do at home to screen for POTS. Explore additional information at POTS NEWS.

Dr. Scheldon Kress is a specialist in Internal Medicine with over 30 years of clinical experience caring for patients and pioneering behavioral management strategies to help patients make healthy lifestyle changes with respect to weight loss, stress management, diabetes management and smoking cessation. Passionate about helping patients manage difficult to diagnose medical conditions, he became interested in POTS when several family members and friends struggled with the symptoms, proper diagnosis and effective management of POTS.

Observing the challenges of POTS first-hand, he began to provide POTS patients and their families with a better understanding of causes and potential treatments, while at the same time teaching them how to utilize an effective behavioral change program to manage their POTS symptoms. This self-directed program is a must-read for patients and families dealing with POTS to empower them to take back their lives and achieve POWER over POTS.

Five Star Reviews

Extremely helpful and informative

My daughter has been suffering these symptoms for months. She, like many others, has been misdiagnosed with neurological diseases and mental illness. Even with her heart rate being 30 beats different and multitude of symptoms, doctor was still skeptical because of her blood pressure not changing. Doctors are not educated on this syndrome and it’s extremely hard to find one that is. This has brought a lot of stress to our family, however, as her mom, I persevered, held my own and kept on researching. I came across POTS, educated myself and now we know what’s wrong and how to fix it. This book was one of the books to help us get there. Thank you for publishing this extremely helpful information!

- Praha2014, Amazon

I would like to thank Dr. Kress for writing this book and bringing much needed attention to this illness. POTS is something I have struggled with for many years and I appreciate how thorough and descriptive the book is. The first part of the book expertly describes the ins and outs of finding a diagnosis and how to recognize POTS in a patient. The second section of the book is perfect for families trying to navigate the lifestyle changes that a patient and the rest of the family go through in order to make recovery easier. The book covers all the bases for someone who is looking for more information about POTS. I will most definitely be sharing this book with friends and family and continue spreading the word of this most amazing book.

- Mary Beth, Amazon

The Best POTS Book Available!

This book was extremely helpful in helping my family understand and navigate POTS. The medical information is outstanding and the explanations for the behavioral changes necessary to improve POTS symptoms are easy to understand. I would recommend this book to anyone who is interested in learning more about POTS or wants to lessen their POTS symptoms to feel better. It really is a fantastic book and I like that it is written by a medical doctor who really understands how POTS affects every aspect of a patient's life.

- Angelina, Amazon

This book was incredibly helpful in educating me and helping me manage my child's difficult medical condition.

- Karen, Goodreads

Additional Information

I hope you find my book to provide helpful information on the subjects discussed. The book is not meant to be used, nor should it be used, to diagnose or treat any medical condition. For diagnosis or treatment of any medical problem, consult your own physician. The publisher and author are not responsible for any specific health needs that may require medical supervision and are not liable for any damages or negative consequences from any treatment, action, application or preparation, to any person reading or following the information in this book. References are provided for informational purposes only and do not constitute endorsement of any websites or other sources. Readers should be aware that the websites listed in this book may change. The author is no longer in private practice and not in a position to respond to any medical inquiries.