I appreciate all the comments - very helpful and interesting. It is looking as though I do have adrenal insufficiency of some sort as my ACTH stimulation test came back abnormal. It was not conclusive, but still abnormal. They want to do even more specific adrenal tests now.
Maybe one day I'll have an answer. In the meantime they're keeping my bp up artificially as best as they can.
I have inappropriate sinus tachycardia and when I started treatment my bp improved. Now it can be as low as my previous 90/60 and sometimes a high normal, but usually is something around 110/70. I take atenolol and verapamil ER.
"There is recent data to suggest that IST may be causes by auto antibodies to the beta receptor that stimulate incessant tachycardia. It can follow a period of viral illness like symtpoms."
I'd love to read the research on this. Since viruses and autoimmune processes are suspected in the development of PPCM (and other cardiac issues), I have a keen interest in how things like this come about.
Get an endocrinologist to do a complete check of hormone levels.
Hello,
I am sorry to hear about your frustrations. As a physician we see cases like this sometimes and we scratch our heads.
It is important to rule out things like adrenal insufficiency. One problem is that hypotension and tachycardia can be symptoms caused by many organ systems -- this makes it tough to narrow down a diagnosis.
Cases like this often take time and resources to figure out and often are made as diagnosis of exclusion rather than a single test proving you have a certain diagnosis. There is an entity that will may read about called inappropriate sinus tachycardia (IST) and another called POTS (postural orthostatic tachycardia syndrome). These are difficult diagnosis to make and difficult things to treat. There is recent data to suggest that IST may be causes by auto antibodies to the beta receptor that stimulate incessant tachycardia. It can follow a period of viral illness like symtpoms.
I do not have enough information to diagnose you with these conditions but want to let you know that these are two conditions that can present as you describe.
I hope this is helpful and wish you well.