Do I have POTS? Is a TEE exam scary?

Posted by bellaphillips @bellaphillips, Dec 22, 2022

Hello everyone! I'm a 20 year old female (5’8, 120lb) and I've struggled with heart 'palpitations' my whole life, but over the past year and a half, it's only gotten worse. I had been standing for some time and then out of nowhere my ears started ringing, had loss of vision, started to pass out, body went numb. Went to doctor, I had an abnormal EKG, got echocardiogram where there was trace regurgitation in some areas and a small echodensity found (getting TEE exam done for this).
However, something I've noticed (from a young age) is every time I stand up, I get really lightheaded, I've even passed out before. Today, I sat for 10 minutes, took pulse while sitting, it was at 92BPM and then after standing for 15 seconds it went to 122BPM. Is this an indicator of POTS? If so, how does a doctor check for it, and what has to be done? Also for TEE exam: is it easy to breathe with it down your throat, are you awake or asleep?

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My mom had a TEE at 80 years old, and she was twilight sleep anesthesia, I believe. No worries.

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Yes, it does appear at this point, based on what you have posted, that you have POTS.

The TEE is necessary, and you'll almost certainly be 'out' for it. You can't swallow, and you'll have too much anxiety as they attempt to insert the device. So, you'll be put out with propofol or something similar. I had it done as part of my atrial ablation in July. They need the proximal assessment of damage to tissue and to get a better picture of where the heart is in relation to the esophagus. This is what the TEE offers them...and you.

Try not to fret. I know that sounds patronizing, but it's really the most heartfelt advice any of us who have lived with heart disorders and their hopeful fixes can offer you. They know what they're doing, and they want to help you. This is part of the plan. If you need to worry about something, worry that they'll find 'nothing wrong'. They can't do that by guessing.....sooooo.....grit your teeth and get on with it. 😀

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Just to assure you, the TEE is not to be feared. I have had 4 TEE’s during the past year and a half in conjunction with the implantation of a Watchman Device. Going into the first TEE, I had concerns similar to yours: “Would I be able to breathe?” I was assured that this would not be a problem, and it was true. Benevolently, patients are given anesthesia before the instrumentation is inserted into the esophagus. In my case the injection included a small amount of fentanyl, which has a bad reputation when improperly used outside of a medical setting, but is otherwise a very useful medication. Your trachea, for breathing, is not affected. Because of the medication, I have no recollection of the procedure, but was told that I was able to respond to commands during the procedure. For one of the TEE’s, I did regain consciousness as the instrumentation was being withdrawn, but it was not uncomfortable. Full recovery did take a few hours and I slept a lot, being very tired. Overall, I recommend going forward with the procedure, as it provides useful information to your medical caregivers so they can help you. Ask all the questions you can think of beforehand, and go bravely forward. Best of luck to you!

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