Aa
Do I have dysautonomia?
I went to the cardiologist today with the following symptoms: lightheadedness, low heart rate, low blood pressure, fatigue.
This has been going on since April and I finally went to my family doctor about it in August. Since then, I have had two holter monitors which showed my rates in the 40s-60s and up to 150 with exercise. I used to exercise regularly 3-4 times a week for 30 minutes. Now I am lucky if I exercise 2-3 due to I am always tired. My blood pressure is good and normally runs borderline 90/60, and sometimes higher. It has been as low as 74/56, but I don't think that happens often.
I consider myself very healthy but do not think it is normal to feel tired and sluggish all of the time. The nurse practictioner mentioned a possible autonomic disorder and ordered a tilt test and echo next week. Has anyone else experienced these same symptoms?
This has been going on since April and I finally went to my family doctor about it in August. Since then, I have had two holter monitors which showed my rates in the 40s-60s and up to 150 with exercise. I used to exercise regularly 3-4 times a week for 30 minutes. Now I am lucky if I exercise 2-3 due to I am always tired. My blood pressure is good and normally runs borderline 90/60, and sometimes higher. It has been as low as 74/56, but I don't think that happens often.
I consider myself very healthy but do not think it is normal to feel tired and sluggish all of the time. The nurse practictioner mentioned a possible autonomic disorder and ordered a tilt test and echo next week. Has anyone else experienced these same symptoms?
I'm not sure. They didn't seem too concerned that I would need a pacemaker. The holter recorded my heartrate in the lower 40s, but I think that was while I was sleeping. My heartrate dropped to 37 when I passed out during the tilt test.
POTS is postural orthostatic tachycardia syndrome. If your heart rate goes up 30+ beats per minute with standing, it is an indicator of having it. It is typically diagnosed using a tilt table. The other criteria I personally never got tested for, and that is a standing plasma norepinephrine of 600 pg/ml (3.5 nM).
Since you have more bradycardia than tachycardia, perhaps that is why they decided on a diagnosis of NCS, but in my non-professional opinion, I wouldn't think one faint after nitro on a tilt table is sufficient to diagnose someone with it. I would think that fainting under normal conditions as well should be a criteria for that diagnosis.
I know they try to tell you low salt intake is healthy, but a cardiologist advised me where this is not what he normally would tell his patients, to eat pizza (evidently high in salt)!
What kind of ejection fraction did you have with an echocardiogram? Did they think you had the kind of bradycardia that warranted considering a pacemaker?
Since you have more bradycardia than tachycardia, perhaps that is why they decided on a diagnosis of NCS, but in my non-professional opinion, I wouldn't think one faint after nitro on a tilt table is sufficient to diagnose someone with it. I would think that fainting under normal conditions as well should be a criteria for that diagnosis.
I know they try to tell you low salt intake is healthy, but a cardiologist advised me where this is not what he normally would tell his patients, to eat pizza (evidently high in salt)!
What kind of ejection fraction did you have with an echocardiogram? Did they think you had the kind of bradycardia that warranted considering a pacemaker?
Thank you for the information! When I go back I will ask about the iron testing.
What exactly is POTS? How is that diagnosed? I have more bradycardia than tachycardia, or at least that is what the holter showed.
I definitely agree I probably need to increase my salt since I don't each much. I thought low salt intake was healthy lol!
What exactly is POTS? How is that diagnosed? I have more bradycardia than tachycardia, or at least that is what the holter showed.
I definitely agree I probably need to increase my salt since I don't each much. I thought low salt intake was healthy lol!
When you calculate in things like milk with your cereal, liquid in your soup, etc., if you have those sorts of things, I'm thinking you may be overloading a bit on liquids, with that 10 eight ounce glasses worth daily. And if you are drinking gatorade, I recommend you brush your teeth after, because I've heard that stuff is hard on teeth enamel.
You may want to ask about the compression stockings- I believe they help some people, though I found them too troublesome to put on, but only after shelling out a lot of money for a pair of Jobst stockings. With how low your blood pressure is, it sounds like it wouldn't hurt to up the salt. With me, I can get an over-compensation with standing and my blood pressure can spike. So, I have to be careful- I eat salt when my urine is dilute and I feel a certain kind of crummy way, but I shouldn't eat too much, because that has given me a migraine before.
Since you never passed out before the tilt table test and have felt faint, but it sounds like not fainted since then, I question the diagnosis of NCS and would recommend getting a second opinion from a doctor that is well versed in dysautonomia. Because NCS is neurocardiogenic syncope, which has fainting in its very name! And, while some faint who have P.O.T.S., others don't.
Additionally, you mentioned feeling tired and sluggish. Besides mentioning a possible autonomic disorder, did the nurse practicioner order a ferritin (iron stores) and iron saturation percentage level on you to be sure you are not iron deficient? Did she check your thyroid function? How about your B 12 level? I hope so. If not, please do ask about getting these checked. And a person can be iron deficient before it makes any thing in a complete blood count go outside normal range, so they should order iron testing, not just a CBC.
You may want to ask about the compression stockings- I believe they help some people, though I found them too troublesome to put on, but only after shelling out a lot of money for a pair of Jobst stockings. With how low your blood pressure is, it sounds like it wouldn't hurt to up the salt. With me, I can get an over-compensation with standing and my blood pressure can spike. So, I have to be careful- I eat salt when my urine is dilute and I feel a certain kind of crummy way, but I shouldn't eat too much, because that has given me a migraine before.
Since you never passed out before the tilt table test and have felt faint, but it sounds like not fainted since then, I question the diagnosis of NCS and would recommend getting a second opinion from a doctor that is well versed in dysautonomia. Because NCS is neurocardiogenic syncope, which has fainting in its very name! And, while some faint who have P.O.T.S., others don't.
Additionally, you mentioned feeling tired and sluggish. Besides mentioning a possible autonomic disorder, did the nurse practicioner order a ferritin (iron stores) and iron saturation percentage level on you to be sure you are not iron deficient? Did she check your thyroid function? How about your B 12 level? I hope so. If not, please do ask about getting these checked. And a person can be iron deficient before it makes any thing in a complete blood count go outside normal range, so they should order iron testing, not just a CBC.
No, I have never passed out prior to the tilt test, but I have felt faint since then. I am drinking at least 16 oz of a sports drink everyday and at least 64 oz of water. I still have my caffeine but I am watching how much. They have not mentioned compression stockings, but I probably need to increase my salt intake more.
I passed out too after nitro, but I had never fainted before and haven't since and I was diagnosed with P.O.T.S.. Did you ever faint prior to the testing or have you fainted since the testing? Your heart rate is going up when you exercise, according to what you mentioned. It was explained to me that with P.O.T.S., the heart races in order to prevent me from passing out.
I was told to eat more salt but no doctor told me how much. You don't want to get dehydrated by drinking too little, but on the other hand you don't want to drink too much either. Occasionally, my urine is really dilute and I start feeling a certain way, so I shake some salt on my hand and eat it. Did they recommend compression stockings to you?
I was told to eat more salt but no doctor told me how much. You don't want to get dehydrated by drinking too little, but on the other hand you don't want to drink too much either. Occasionally, my urine is really dilute and I start feeling a certain way, so I shake some salt on my hand and eat it. Did they recommend compression stockings to you?
You are reading content posted in the Autonomic Dysfunction Community
Are there grounds to recommend coffee consumption? Recent studies perk interest.
Salt in food can hurt your heart.
Get answers to your top questions about this common — but scary — symptom
How to know when chest pain may be a sign of something else
A list of national and international resources and hotlines to help connect you to needed health and medical services.
Herpes sores blister, then burst, scab and heal.
