Low BP, Spiking Heart Rate during sleep, Dizziness, Short of breath?

[angrymissy]

Sooooo Dr. Steve,

I was getting a bit short of breath and dizzy lately, and had chest pain when exercising, so my doctor put me on a holter monitor. The results showed that several times during the 24 hours, my heart rate jumped to 160 when I was totally at rest... and frequently when I was asleep.

They referred me to a cardiologist today, who didn't really tell me anything except my blood pressure is too low (100/60, I think?), I have a bit of a heart murmur (knew this already) and that I need to get blood work, echocardiogram and stress test. No coffee, cigs, exercise or stress.

My mother died of a heart attack at age 39 due to a blood disorder, hypereosinophilic syndrome. This doc didn't even bother reading it where I clearly marked it on that chart, but said my symptoms could be indicative of that.

At first I thought this was all anxiety, but 2mg of Ativan makes me feel relaxed and still have these symptoms (I usually take 1mg for anxiety).

SO. All of these tests are scheduled for next week, and of course, I'm freaking out.

Questions:
What can I eat high in sodium that is not severely unhealthy? Can I get some kind of salt tablet? Do I need a salt lick like a horse?

How on Earth can I have really low BP, yet spiking heart rate??

Do I really need to cart my ass to the ER if I feel it racing? What should I be on the lookout for as OH SHIT, GOTTA GET TO THE DOC?

What the hell is wrong with me? Again, initial symptoms are short of breath, dizziness, spiking heart rate during rest, low blood pressure, chest pain exercising.

[sink]

Rumor has it that those symptoms are from obsessive use of ecstasy during ones drug filled youth.

[boosterp]

Are you drinking a water?

[biggirl]

is 100/60 that low...cause that is what mine is all of the time, which I am grateful for because high blood pressure runs in my family.

Good Luck Angrymissy...I hope they figure it out and fix it.

[Dr Steve]

Sooooo Dr. Steve,

I was getting a bit short of breath and dizzy lately, and had chest pain when exercising, so my doctor put me on a holter monitor. The results showed that several times during the 24 hours, my heart rate jumped to 160 when I was totally at rest... and frequently when I was asleep.
Ok, first off, I almost missed this post because as a mod you can create your own threads anywhere you want. :smile: but I always pay attention to any thread that has the words "angry missy" in it.

secondly, 160 BPM at rest is definitely abnormal. that would make one think of things like "Supraventricular tachycardia" (supra=above, ventricular=pertaining to the ventricle of the heart, tachy=fast, cardia=pertaining to the heart or heartbeat), or "paroxysmal atrial flutter" (paroxysmal=happening unexpectedly at random, atrial=pertaining to the top part of the heart, flutter=flutter)


They referred me to a cardiologist today, who didn't really tell me anything except my blood pressure is too low (100/60, I think?), I have a bit of a heart murmur (knew this already) and that I need to get blood work, echocardiogram and stress test. No coffee, cigs, exercise or stress.

definitely quit smoking and drinking caffeine. They didn't tell you anything else? By the way, how long did the episodes last on the monitor?



My mother died of a heart attack at age 39 due to a blood disorder, hypereosinophilic syndrome. This doc didn't even bother reading it where I clearly marked it on that chart, but said my symptoms could be indicative of that.

that's really easy to diagnose. eosinophilia (an over-abundance of a certain kind of white blood cell) can be detected with a simple blood test, called a "Complete Blood Count with Differential". Your primary care person can do that for you if you didn't already have one.



At first I thought this was all anxiety, but 2mg of Ativan makes me feel relaxed and still have these symptoms (I usually take 1mg for anxiety).

no, 160 beats a minute is not anxiety.



SO. All of these tests are scheduled for next week, and of course, I'm freaking out.

ok! what tests are they going to do, do you know?

you can email me, you know, at drsteve202 at gmail dot com anytime. (that goes for the rest of you maniacs as well)

Questions:
What can I eat high in sodium that is not severely unhealthy? Can I get some kind of salt tablet? Do I need a salt lick like a horse?

wait, why do you want to eat salt? did someone tell you your sodium was low? I need to go back and reread your post.

How on Earth can I have really low BP, yet spiking heart rate??
because when your heart rate spikes that high, your heart can't pump blood effectively so the blood pressure decreases.

Or if your blood pressure is always low, the two just don't correlate.



Do I really need to cart my ass to the ER if I feel it racing? What should I be on the lookout for as OH SHIT, GOTTA GET TO THE DOC?

If they could catch it in the act, it'd be a lot easier to diagnose and treat. In the end, if it happens a lot, they'll give you medication to decrease the frequency and duration of the episodes. All depends on the diagnosis. The heart is an electrical organ...the guys who are best at figuring this out are "ELECTROPHYSIOLOGISTS". The cardiologist may want to send you to one if they can't get you under control. EP docs are just cardiologists who have decided to specialize in electrical disturbances in the heart.

What the hell is wrong with me? Again, initial symptoms are short of breath, dizziness, spiking heart rate during rest, low blood pressure, chest pain exercising.

Ok, you're married to FOUNDRY MUSIC JEFF. Really, do you need me to elaborate? :smile:

seriously, though, this is the kind of thing the cardiologists love. the problem is discoverable, the answer is knowable, and it makes them look like geniuses (which many of them are.)

This is a very common problem that has a definite solution. So I'm betting you'll be ok. Finding the source of the problem is goal #1.

Go to the ER if you feel faint, or if you actually do faint, or if you have chest pain associated with fainting, sweating, nausea, or palpitations. If it happens and it lasts long enough, definitely go to the ER and see if they can catch it in the act.

Call or write anytime. Keep us in the loop.


your pal,



steve

[Dr Steve]

Missy:

In the light of day I reread your post. There are many things that can cause low blood pressure and tachycardia.

The adrenal glands have a lot to do with salt retention and low blood pressure...they'll likely do a test for this. Easy to treat if that's what it is.

If you have fainting or near fainting they may put you on a "tilt table" to test your "autonomic nervous system" to analyze when your blood pressure drops and under what circumstances.

I'd really like to see that holter...it's not impossible that there's no real "arrythmia" at all, but rather just your heart compensating for the low blood pressure by beating faster. That's called "sinus tachycardia" and 160 is admittedly pretty fast for this, but not impossible in bursts. This is pretty easy to tell just by looking at the tracing on the holter. That's the one bit of info I just don't have.

Also, it's not just about taking in salt...it's about retaining it, and the fluids that go with it. Gatorade is a reasonable rehydration solution that you can buy anywhere. It's not perfect, but it does have some electrolytes in it. For ideopathic hypotension (low blood pressure for which we know no cause), giving a steroid that causes salt retention (fluorinef) is sometimes used by providers. You can drink V8, too...that shit has 2 days worth of salt in a 4 ounce can.

Let us know when you find out more!


your pal,



steve

[angrymissy]

hah, I kinda threw the salt thing in there without explaining. After he told me my bp was too low, he said I need to eat a lot of salt and drink a lot of water. He said once I have my "menses" (who says that anymore) and "everything comes out" (fucking gross), it could go lower. My bp has been low my entire life, docs always mention it to me.

He was very quick, in and out, and all he mentioned was no smoking, no caffeine, and try to stay relaxed and not get my heart rate up (HAHAHAHAHAHAHAHAH that falls back to the "living with FMJEFF" comment). Is there anything else I should be avoiding? The caffeine is going to be harder than the cigs. I don't drink a lot of it, but have had a big cup of coffee in the AM since I was 13.

The tests I am having done are blood work (today), echocardiogram (Monday), and a stress test (Tuesday). I guess he really can't diagnose shit until those are done, right?

They did not tell me how long the episodes lasted, just that there were several during the 24 hours, that they were spiking to 150-160, and that they were concerned about it happening during sleep (I wasn't having nightmares, I was dreaming about finding $600 shoes for $20 and my sister and I buying them and being thrilled)

Can I still take an Ativan? Of course the whole idea of this makes me crazy nervous.

Could this have been caused by Adderall? From approx Mar-June I was taking 10mg Adderall XR a day. I stopped in June b/c I was in a car accident and taking painkillers, and did not want to mix too many meds.

[angrymissy]

Oh, and I'm guessing this cig thing has to be cold turkey... no gum or patches or anything because the nicotine will still affect my heart rate?

[FMJeff]

I want to make it clear to everyone reading this that I am NOT the cause of my wife's cardiology problems. The only thing I kill my wife with is kindness.

Thank you.

[disneyspy]

I want to make it clear to everyone reading this that I am NOT the cause of my wife's cardiology problems. The only thing I kill my wife with is kindness.

Thank you.

QUIT TRYIN TO KILL YOUR WIFE!

[Lady Resin]

I just found this on MSN. 3 Alternatives to Coffee.

http://health.msn.com/nutrition/articlepage.aspx?cp-documentid=100242803&gt1=31036

[DH 215]

I want to make it clear to everyone reading this that I am NOT the cause of my wife's cardiology problems. The only thing I kill my wife with is kindness.

Thank you.

Sounds like a guilty person to me. :)

[topless_mike]

I want to make it clear to everyone reading this that I am NOT the cause of my wife's cardiology problems. The only thing I kill my wife with is kindness.

Thank you.

and excessive vomiting.
just sayin...

[KatPw]

I want to make it clear to everyone reading this that I am NOT the cause of my wife's cardiology problems. The only thing I kill my wife with is kindness.

Thank you.

Laying down your alibi for the insurance adjuster?

[Dr Steve]

Ok, I reviewed your holter monitor, and I don't see any beats faster than about 130 and those are extremely infrequent (just a beat here and there). This looks like the monitor of someone who smokes and drinks coffee. :smile:

so quit. (congratulations on your progress so far on that, by the way...it ain't easy, but it is worth it. Oh, and you know what non-smokers do? THEY DON'T LET PEOPLE SMOKE IN THEIR HOUSE)


get more exercise to get your resting heart rate down.

tell Jeff to quit trying to kill you.

come to TN and move in with us...no wait, that'd be bad for MY heart rate.


I think you're going to be ok. Let me know if anything else turns up!


your pal,


steve