Irregular heartbeat?

[assured]

I am a 45 yo female.  History of anxiety/panic attacks.  In February 2006 I went to the ER with SOB and chest pain.  I remember the term IST after my EKG.  The cardiologist  admitted me.  Over the next three days I had blood work, Echo, thallium stress test, monitoring, and a catheterization.  I was told it was anxiety, had exercise intolerance and needed to lose weight (I weighed 175 at that time).  I have since lost 45-50 pounds, but still do not exercise.

I always had normal bp (120/80).  After losing weight, I noticed it was more likely to be 115/75.  I was diagnosed with Hashimoto's last October and am on Synthroid .50  mg.  When I went to the endo my bp was 121/92, and each subsequent time at his office my diastolic would be in the low 90's.  

I purchased a home bp monitor in order to keep track in case there was a problem.  (I got an Omron model.)  I was surprised to find that my bp at home was actually low, usually in the 90's/60's.  The lowest I've ever had it read was 81/55. But, at the doctor's office it would be high, 130/90.  I saw the cardiologist again 2-3 months ago to run this by him and he did an EKG and said he'd see me in 6 months.  He feels that I have either an auto-immune or endocrine problem that is causing my symptoms (bp fluctuations, Raynaud's, skin flushing).  I had extensive blood work done at the rheumatologist which did not indicate any other auto-immune disease other than the Hashimoto's and Raynaud's.

Is the fluctuation in bp concerning?  I do sometimes feel lightheaded (mostly when seated).  Could this be a form of dysautonomia?  My cardiologist indicated that was a possibility but didn't offer testing.  

Lastly, my bp monitor sometimes gives me the "irregular heartbeat" symbol.  This occurs when I sitt down and take my bp without waiting the 15-30 minutes the instructions say.  If I then sit quietly and then retake it is normal.  Anxiety does cause my pulse rate to fluctuate a lot as well.

Thank you,

Cindy

[assured]

I appreciate your response.  I guess I was a bit convoluted in my question.  What I am most concerned about is the "irregular heartbeat" symbol and whether that actually indicates I have a rhythm problem or is the fact that I'm not sitting quietly for a period of time before I take my bp causing that to come up.  

Cindy

[Michael J. McWilliams, M.D.]

It is common for blood pressure to be higher at the doctors office. That is quite a swing but suggests that you might be pretty anxious to see your doctor -- whether you overtly recognize this or not.

It could be dysautomia.  There are not great tests or treatments for this though.  I am not sure what tests I would offer either.

The home blood pressure tests are a mixed blessing.  Some information is ok but there comes a point when people can obsess about it and this only adds to the blood pressure pulse issues.  I can't really assess over the internet if you are taking it too often but i have certainly seen it before.  I am not sure what else to say.  These can be difficult situations to treat because it is hard to pinpoint the exact problem.