Fluctuating Pulse and Blood Pressure

[kathyw]

For most of  my life my heartbeat has been moderately  fast--from 90 to 110 and my blood pressure has been really low--like  100/60.    However, for the last few years I have had some really wide variations and have experienced extreme fatigue.  I started occassionally having really rapid heartbeats that I could

even feel in my ears when I laid down.  They usually lasted less than an hour.  I decided to take my  blood pressure one night when this was happening and the diastolic was 105.  Systolic was around 140 to 150.  This has happened several times since and the attacks are not usually associated with stress and blood pressure goes back down to fairly low again after a few hours or days. However,  for the last several months, my pulse had decreased to in the 70’s.  Then last week when I was getting ready for bed, I had a really strange sensation in my neck and chest that I guess was a flutter or palpitation.  It happened several times within about 20 minutes.  Each attack would make me a little nauseous and breathless, but nothing permanent.

I’ve also had some slight pain and pressure in my left chest area going into the shoulder, but it doesn’t seem to beassociated with exertion, and it’s not deep   (I have fibrocystic disease).  

Anyway,  this last attack scared me enough to go to the ER.  (I am 51 and my father died of a massive heart attack at age 52).  My pulse there as about 114 and only went down to 106 after an hour on an antianxiety medication;  my blood pressure was on the high side of normal.    My EKG showed slightly flat T waves in

most leads and mild ST depression in lead I and V3-V6.  So the

ER doc suggested I have a stress test.  My potassium was also

low--3.1. I took  liquid potassium.  I had the stress test the next day and it showed ST-T changes suggestive of ischemia so I had the cardiolite test the next day.  Myoglobin  was 16.7f the first day and 93.5f the next, but troponin was normal both times

and potassium was back to normal.

The cardiolite scan was normal.  They told me that women have a high percentage of false positives on stress tests, but I had an EKG about a year ago and it was normal.  The doctor put me

on 1/2 pill of Lopressor twice a day and it has seemed to help

stabalize everything.

   I'm sorry this is so long and I know you can't diagnose, but it has been a week and I haven't heard anything from my doctor,

and I'm quite concerned as to whether I need further consultation

and or testing.  There was no reason the potassium should be

low--no diuretics,  good diet, etc.  If you could just steer me

in the right direction, I would appreciate it.

[Cleveland Clinic, MD]

Dear Kathy,

It's not entirely clear to me what is going on but it does not sound like the heart is involved.  It is unusual for the potassium to be that low.  I would suggest seeing an internal medicine doctor to review all your records and determine if any additional testing needs to be done.  Most likely everything is within normal limits and nothing additional will be needed.

[mardi9b]

A related discussion, pulse vs blood pressure was started.