i have been diagnosed with autonomic nervous system dysfunction. however, the one who diagnosed me is a cardiologist -- not a nerologist. he wants me to undergo a tilt test and a coronary angiogram, in order to determine the possible causes. i did some research, but i did not come across either test in the diagnosis or treatment of the said dysfunction. both tests cost a bit, so i would like to know if they are really necessary.
my symptoms: dizziness when in an upright position (especially when standing), weird bp (low even when it is expected to rise--e.g.: during a stress test, the highest bp i had was 120/something, and after that, it went down to 60/40), weakness, easy fatiguability, history of syncope, low skin temperature when my temperature is expected to rise (e.g. after a treadmill exercise), minimal sweat when i'm expected to be sweating profusely (e.g. after a treadmill exercise -- modified bruce protocol)
for your comments please.
by the way, a little about me: i'm 27, female, tested negatively for thyroid conditions, 2d-echocardiogram revealed very mild (per my doctor, insignificant) mitral valve prolapse, with history of asthma, bronchitis, and rhinitis. allergies: dust mites, pollen, crabs, shrimps.
thank you. - mcbg
by the way, i was given inderal (propranolol i think) for my mvp by a different doctor. i also experience fine tremors (hands) at times, and before fainting/before a possible syncope, i experience a certain numbness around my face, my mouth begins to twitch, and i feel a tingling sensation in my fingers before they start to curl up and become rigid. i have learned to lie down as soon a begin feeling those symptoms that i experienced prior to fainting, so i guess that's why i don't faint anymore.
I hope this helps a bit. I believe the reason for the angiogram is due to the drop in blood pressure during exercise. This is very abnormal, especially for someone your age and on a modified protocol. Someone your age should be able to walk 12 minutes or more on a standard Bruce protocol. Did he mention the term "neurocardiogenic syncope"? Google it. It's a big word describing a bunch of symptoms. The tilt table will show this if you have it. If he makes a diagnosis of this disorder, it is treatable with beta-blockers (which you are already on) or there is another medication just for this kind of problem. I think the cardiac work-up is in order first, then if nothing is abnormal a neuro work-up. It sounds like this problem is significantly affecting your life. Which test are you doing first? You and your doctor will have to make the decision regarding the testing. Did you read about the coronary angiogram and the tilt table test? You should be able to find lots of info. on the net about these tests.
thanks a lot patsy. i guess i didn't read enough. wasn't feeling too well anymore, so i decided to just ask instead of doing more reading. he didn't mention the term "neurocardiogenic syncope" but he did say that the tilt test would help him come up with a differential diagnosis for my fainting spells and feeling of lightheadedness when in an upright position, especially when standing.
we haven't discussed what test we would be doing first, but another doctor will be examining me (perhaps tomorrow) and give his input. then we decide.
Your symptoms sound like classic Dysautonamia -- what your doctor described as dysfunction or disregulation of the autonomic nervous system. There are a number of websites on the disorder. Unfortunately, the treatment protocol is dependent very much on the individual with the disorder, which means that a lot of people have to try a collection of medications before finding one that works for them.
Dysautonomia is commonly found with mitral valve prolapse and reynauds (cold hands and feet).
Good luck with your treatment. I hope you find a program that works well for you.
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