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Standing Dramatically Raises HR and Diastolic BP

Hi,

I am a 60 year old female, a little chunky, not obese.

I have never smoked, never used alcohol, never used any illegal drugs and never abused any prescription drugs.

I have low cholesterol (thank you lipitor, zetia and flaxseed oil)  #:>)  

And I have very mild hypertension (cardizem la 120mg daily) easily controlled and with a usual sitting BP of 110/70.
(Sometimes, I can go for months without needing any medication for the hypertension.)

I have had unexplained shortness of breath most of my life.  I have an air diffusion rate of 41% (DLCO) and I test positive for obstructive breathing function.

I have allergies and take allergy injections weekly.




I am very concerned (due to increase in severity of symptoms) because:

Whenever I stand, my HR and diastolic BP rapidly increase.

Within a moment or so, my HR rapidly increases its rate by about 60 points to 125 - 135 BPM and continues to climb.

My diastolic BP rapidly elevates about 40 points and continues to climb.

My systolic BP remains similar to the sitting BP with only a slight variation of a few points (up or down).

As long as I stand, The HR and BP contine to climb until they reach a point where my BP monitor can not detect it.  It will give me an E  error message which means it can not detect a pulse.

While I am standing my head hurts; my heart hurts, my legs and hands shake, my face reddens and I sweat profusely.  I am profoundly short of breath.

I have intermittent nausea especially after standing.

I have transient dizziness - standing, sitting or lying down.

As the day progresses, I feel worse.  

I have also been experiencing chest pain that awakes me from a sound sleep (as much as twice a week as little as once every 6 weeks.)

I recently had an echo that stated:

Mild left venticular hypertrophy
Mildly dilated right ventricle
Mild Aortic regurg
Mild Mital regurg
Trace Tricuspid regurg


I had a holter monitor test.
The Holter monitor demonstrated frequent ventricular ectopic beats, 37 supraventricular ectopic beats, isolated PACs, couple PACsone 5 beat atrial tachycardia at 150 bpm.  During maximum sinus rate there was some mild, fairly horizontal or slightly downsloping ST segment depression.  Notation that myocardial ischemia could be considered.
Lowest heartrate 43 bpm.

During the holter monitor testing, I felt too weak to do any physical activity due to my symptoms.

I did push myself to wash and blowdry my hair because I knew that the activity would trigger the irregular rhythms.
The 150 bpm were during the time that I was blowdrying my hair, (not running, not exercising, not working out).. I was just standing and blowdrying my hair and taking sitting breaks when I couln't stand.


Several years ago, I had an elevated normetanephrine and elevated alkaline phosphatase but I do not know if that is related.

My daughter also has had on going trouble with arrythmia, often feeling like she is going to pass out and shortness of breath issues also.  She is petite, thin and very fit but struggles during exercising because of the feeling of impending collapse or fainting.

I would appreciate any wisdom or insight into this matter.


3 Responses
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21064 tn?1309308733
Good for you for following through!  Let us know how the tests go.
Helpful - 0
Avatar universal
Thanks for your comments.

I did consult with another cardiologist.  

She said PVCs aren't too important unless you have underlying heart issues, then it is a concern.

She reviewed my films, sent me for "stat" blood work and made an appointment for me with an electrophysiologist.

She said that I need to get this under control.

She said NO Caffeine and do not exercise until I have completed my tests.



Helpful - 0
21064 tn?1309308733
The symptoms you describe warrant a call to your doctor, or a visit to the ER.  Whenever you have new or worsening symptoms, it's better to be safe than sorry.

I can tell you that it is not atypical for a rise in HR in people who are deconditioned.  Do you exercise?  The change in your HR is pretty dramatic, so you should def. have it checked out.  The fact that it "continues to climb" may be indicative of somethin going on.

If your BP is climbing beyond the readings available on your machine, that seems to indicate a pretty high BP.  When I was having PVCs, I could hardly ever get a reading....Do you know if you're having extra beats (they feel like skips in your heartbeat)?

I'm not sure about the significance of some of your echo report.  However, it is very unlikley that the amount of valve regurgitation you have would cause your symptoms.

I don't know the significance of "mild, fairly horizontal or slightly downsloping ST segment depression".  The PVC's, PACs, tachy may be normal for you.  I would have some concern over the comment: "myocardial ischemia could be considered".

What does your doctor say about the tachycardia?

Helpful - 0
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