Autonomic Nervous System Dysfunction

[jmcruz]

Dear Dr,
I’m 37 yo man, BMI=22,2, usually healthy. In 2000 I was over weighted(BMI nearly 29)and had a High BP episode of 160/100.Did then, in Sept.2000, an EKG, echocardiogram, renal echo and detailed blood and urine testes (usual plus 24 h, thyroid, renal/suprarenal parameters, etc.) that came all fine. All years I do routine med checkup involving EKG, blood and urine tests that are all fine (All years normal EKG and sinus rhythm under 100 bpm –> 2002 values-> EKG normal/sinus/AFreq=VFreq=96bpm, blood and urine tests were Cholest=164, HDL=71, Triglicerids=48, Glucose=79, …). Now with correct weight my BP is controlled without meds – usually 130-140/80-85, only with very sporadic/spaced measures above (but always bellow 160/95), normally related to anxious states.
Sometimes I have high pulse rate in rest (with sweatiness), but some anxious - The max HR was 128 bpm, but usually less in 110’s range that are short time long (max some minutes). When globally calm (physic+emotional+mental) my HR is, usually under 72 and at wake up, sometimes close to low 60’s.
A Dr that is my friend (It’s not my GP. My GP, due to the exams results, isn’t concerned and says is anxiety) told me that it seemed to him the more probable situations are autonomic nervous system dysfunction, supraventricular tachycardia or an anxiety disorder.
The second and third things I know what they are, but the first, autonomic nervous system dysfunction I don’t. Do you agree with that? -  What is it ? – Is it a dangerous situation and to concern serious with it or not?–Are further testing necessary?
Thanks

[CCF-Neuro-M.D.-JT]

An autonomic nervous system dyfunction is possible, but it certainly is not the first second or third thing that comes to mind when someone has a fast heart rate at rest. Thyroid disease and primary heart rhythm conditions should be looked at first and foremost. You may need more prolonged testing of your heartrate like a special holter monitor that you can wear at home for a 24 hour period to see if they can catch the abnormal heart rate. A single EKG at one point in time is not going to cut it when looking for rhythm abnormalities that happen sporadically. Routine blood tests to look for thyroid problems should also be done. A disorder called pheochromocytoma in which excess adrenaline is put out by the body can also cause sporadic increases in heart rate and blood pressure with sweating. Anxiety is also a possibility. Further testing should be considered especially if this happens in the absence of exercise and stress. Depending on what the heart rhythm is and the cause, this may be a serious condition requiring treatment. Get a second opinion or see a cardiologist. Best of luck

[marthaclair49]

A related discussion, autonomic nervous system dysfunction was started.