I am a 22 year old female and 15 weeks pregnant. Since I was about 10 weeks, I would get these dizzy spells, nasuea, panicky feelings, hot and out of breath upon standing...It was mild then but over the last week its been progressively worse..my bp would spike...one time got as high as 169/105! This is upon standing...I also get tachycardic when I stand. My bp laying will be 110/65, sitting 122/75, standing usually 130/90 to 145/100. My heart rate laying will be 75-80 BPM and once i stand it will be 95-120 bpm! When I get out of the shower, my heart beats like 140 BPM. Again, once I lay down these issues are resolved 100%. Ive seen four doctors this week as it has gotten worse. Sunday was when i got that 169/105 reading at the grocery store and blurred vision so I headed over to the ER. Got there, did an ekg,blood work and checked for Preeclampsia and HELLP syndrome. Everything absolutely fine cause of course once I lay im fine and all tests were good. Doc told me it was anxiety and told me to follow up with my OB. Tuesday I saw my OB and again my bp was 150/105. She freaked and gave me a referral to go down stairs to the ER. Well once I got to the ER, it started dropping a little to 140/90 and again i had an ekg, blood test, etc. Laying down it dropped every half hour lower and lower to 118/65 at the lowest. Doc again sent me home with an anxiety diagnosis. I started getting more suspicious, cause I know the difference between anxiety and something being not right. I made an appointment to see my regular MD in hopes of getting some kind of treatment. Well the MD told me she doesnt see anything wrong. ugh, im so frusturated! I have gotten sicker and sicker these last two days and I cant stop crying because what I feel is very real. ive done my research and im thinking i could possibly had POTS or orthostatic hypertension..IDK, thats why Im here...docs wont help me and i feel horrible. I want to be able to do regular things again.. All opinions welcomed. Thanks..
You seem to mix up some terminology here, when mentioning POTS and orthostatic hypertension. POTS is linked to orthostatic HYPOtension (lowering blood pressure when standing up).
That said, orthostatic hypertension exists (though not with POTS). Your diastolic blood pressure is supposed to increase when standing (which is a normal phenomenon). To explain it briefly:
When standing up, approx. 700 ml (15%) of your blood volume is made unavailable for the heart to pump (it gathers up in your stomach, legs, etc. due to gravity). This is causing lowered venous return to your heart, which again makes your heart pump less blood for each heart beat. Usually, this effect isolated will reduce your systolic blood pressure.
In response, your body will produce a surge of norepinephrine (noradrenaline) which is narrowing your arteries, to prevent you from fainting when standing up. In response, your diastolic blood pressure will increase (and so will the systolic, but this effect is countered by the effect mentioned above). A "mild" version of this will happen when going from supine to sitting position.
A supine blood pressure of 115/65 will usually equal 110/70 sitting and possibly around 105-110/75-80 standing. Due to increased venous return, your systolic is highest when lying down.
From your heart rate and blood pressure when standing, there are three possibilities.
1) You are simply afraid/anxious when standing up (and measuring your blood pressure). When doing so, you are also producing lots of adrenaline which will increase heart rate and heart contractility.
2) You are deconditioned. Which makes your body believe standing up is an "effort" which demands a higher heart rate and/or blood pressure.
3) You are having some sort of autonomic dysfunction/imbalance that is causing your body to misregulate blood pressure when standing. This is extremely uncommon.
A stress test may examine your blood pressure response to effort and exercise, but I'm not sure I would go that far if it's not recommended by your doctor. I had the exact same "problem" but it resolved when I stopped being anxious about my blood pressure.
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