Autonomic Dysfunction Community
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What things could be causing my autonomic dysfunction?

37 year old male. 5'8 150 pounds. 3 ER visits December 2019 - January 2020 for blood pressure and heart rate going up and down, dizziness, short bursts of shortness of breath, lightheadedness, adrenaline, facial flushing, etc. EKGs done at the hospital. Tons of blood work to check for everything, including pheochromocytomas. Numerous primary care doctor visits and blood work. Endocrinologist checked my thyroid. Not diabetic. MRI of the brain with and without contrast showed a healthy brain. Contrast CT scan of the abdomen showed nothing abnormal with any organs. MRI of the abdomen showed nothing abnormal with any organs and ruled out any adrenal tumors. The day after it first began with the first ER visit in December 2019, I went to a Cardiologist. 160/90 blood pressure. He couldn't find a cause. Full Stress Echocardiogram with ultrasound of the heart before and after the treadmill and Color Flow. Healthy with nothing seen. Wore a real-time heart monitor with 5 leads for 30 days and symptoms that got sent to my doctor if there was an issue. Reported hundreds of events of dizziness, palpitations, rapid heartbeat, etc., and that cardiologist stated they saw nothing but half of a second of irregular heartbeat in the first 15 days and that it happened at a time when I didn't even report symptoms. I've seen a Gastroenterologist because in February I started having some severe stomach pains after the household came down with a stomach virus. Upper Endoscopy showed only a red and inflamed stomach lining. Negative stomach biopsy for cancer and H. Pylori.

One primary care doc thinks I have some sort of autonomic dysfunction. He referred me to an electrophysiologist for tilt table testing. Electrophysiologist saw all that I have been through and wants an Echocardiogram and event monitor.

I've started blood pressure logs per my second (new) cardiologist, the electrophysiologist. My blood pressure is all over the place. I've awaken in the morning to 154/121. Other times it drops considerably while sleeping.

This afternoon I took about an hour nap lying down. 4:51pm was 109/72 with 77 pulse. 501pm was 103/73 with 83 pulse. 5:16pm was 106/64 with 77 pulse and 5:18pm was 109/76 with 87 pulse. As you can see, in less than 30 minutes, it is all over the place. Yesterday morning at 7am I had been asleep for hours and while still in bed it was 151/101 with only a 71 pulse rate. When I got out of bed 30 seconds later, it instantly dropped to 124/93 with 85 pulse. SPO2 monitor on my finger showed my heart rate jump from upper 90's to 121 and back within a few seconds, so I've got heart rate going all over the place. Sometimes it doesn't even matter if I'm sitting, standing or lying down, my heart rate will jump 20-30 numbers higher or lower within seconds then temporarily stabilize.

This seems to indicate Dysautonomia/POTS-like behavior. I get short of breath sometimes and dizzy if leaning slightly forward to wash hands over a sink. On days when I sleep 7-9 hours, I'm dizzy all day with it feeling like my heartbeat is too slow and it usually stays in the 70's for most of the earlier part of the day. If I sleep 5-6 hours, I'm not dizzy on some days. It's totally random and stupid. I suspect that on days when I'm getting less sleep, that naturally stresses the body (albeit not good for me, of course) and keeps my blood pressure higher as a result.

2018 - In-lab sleep study showed 4.7 apneas/hour. Early 2020, I've been placed on Bi-Level machine after they logged 64 apneas/hour during another sleep study with another sleep lab. Something happened. I see evidence online that drops in blood pressure can cause pressure in the diaphragm and therefore cause apneas similar to sleep apnea. My sleep doctor, of course, denies this.

Tilt table test coming up in the near future, as well.

One morning I slept pretty badly and woke up at 4am to a 154/125 blood pressure. I reached over and took it with the automatic tested and didn't move much. By later in the morning, it had gone down. Pulse rate was only like 70 at that time. Other days pulse might be 125 and I'll feel dizzy all day.

Neurology/sleep medicine doc appointment in early October for my random neurological "jumps" that happen when I go to pick up stuff, nearly drop something, etc. While sitting upright during the day, if I drift off to sleep, I'll get hynogogic-like jerks that repeat frequently. Pretty strong lower back pain that can cause some sharp shock-like pains that make me jump, as well. Feels like something is being pinched sometimes.

Should I be worried about a heart problem? My first cardiologist said I was healthy and he thought it was anxiety. Yet his reports say:

Palpitations, precordial pain, dizziness and giddiness, abnormal electrocardiogram. His ECG shows sinus tachycardia and poor r wave progression. Has had tsh checked ok, will give a chest press and will do a stress echo with chest pain and sob and near syncope."

Stress EKG showed nothing, of course.
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