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Periodic Blood Pressure Drops
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Periodic Blood Pressure Drops

Since March 2005, my husband has had 4 "episodes", each one a little closer to together with the last two only 3 months apart.  While not changing position (2 of them happened while sleeping, the others while sitting at his desk at work), he starts to sweat, feel his heart beating normal speed but very hard, his fingers start going numb, the room spins, etc.  This usually goes on for 5-10 minutes and then he passes out completely. I was able to check some things while it was happening the 3rd time. When I first checked, before he passed out, his BP was 73/30 and heart rate was 77. I checked it again 6 minutes later, after he passed out, and his BP was 60/29 and heart rate was 86. When the EMT's arrived, his oxygen level was 84 and he was still unconscious. They gave him oxygen and got him stable enough to transport, and he slowly woke up en route as his blood pressure came back up.  By the time he was in the hospital, his BP was 115/60 and the doctors could find nothing wrong with him.  

All 4 times, it has followed the same pattern. During the 2nd time, he stopped breathing twice.  It was like it was just too much work to try to get air and he just got too tired. With a hard chest rub, he started breathing again.

He has had test after test but everything comes back as normal (EKG, EEG, Echo, Stess Echo, etc).  After the last one (that happened this week), they ran a CBC soon after arrival in the ER.  His WBC was 20K (ANC was 17K). By the next morning (about 16 hours later) it was normal at 9K. He had no other signs of infection or virus.

None of the doctors have any idea what is causing it.  He has been on a 24hr Holter monitor a few times but nothing is unusual.  Right now he's got a 30-day King of Hearts monitor on but the cardiologist doesn't think it's going to show anything.

We aren't sure where to turn at this point to get any answers. We've been recommended to go the the Mayo Clinic but we would like to avoid that if possible due to time and expense.

Any help you can give would be great.

Thanks.
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2 Comments Post a Comment
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Avatar_dr_f_tn
Hello and hope you are doing well.

His symptoms could be due to postural hypotension, a condition in which the peripheral arteries dilate, leading to pooling of blood in the peripheries. This in effect causes decreased circulation of blood resulting in dizziness/lightheadedness. This is more pronounced if the person stands up from a lying down position. This is detected by recording the blood pressure recordings in the sitting, standing and lying down positions. If the variations in blood pressure recordings are more than 10 mmHg, it is diagnosed as postural hypotension/Orthostatic Hypotension. Please discuss this with your doctor.

Hope this helped and do keep us posted.
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Avatar_m_tn
Thanks for the feedback. Postural hypotension has been one theory of the doctors but they usually rule it out because it happens while he is sitting or laying down. He will pass out cold without ever getting out of his lying position.  He's having a tilt-table test done in a few weeks, but if that doesn't show anything, I'm not sure where to go from here except just waiting to see if it happens again.
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