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I get odd "pressure" feelings in my face/hands on some days

I'm a fairly healthy 37 year old Caucasian male. 5'8 and 150 pounds. I've been active and muscular for most of my life, exercised regularly, lifted weights, etc. Back in December 2019, I was getting ready for bed one night and my heart started racing. I felt like I was having heart palpitations or something, felt faint, was having adrenaline surges, having trouble walking due to the adrenaline feeling, etc. Between December 2019 and January 2020, I had 3 ER visits. Lots of EKGs, blood work checked for everything life-threatening, an MRI of my abdomen to check all organs, a contrast CT scan of my abdomen, etc. They found nothing, but my blood pressure was 173/100 in December. My head was quite red at that time. They found no reason for it and discharged me from the hospital. I went to a Cardiologist a couple of days later. It was about 163/90 while I was there with him. We did a full Stress Echocardiogram with ultrasound of my resting heart beforehand and also ultrasound of my heart immediately after getting off from the treadmill. He said I had a strong and healthy heart. No known cause of the blood pressure being up and he tried to blame it on anxiety, which I haven't had issues with.

Got a stomach virus in February 2020 that took me out. Black diarrhea for days (another family member had it and had crazy violent vomiting for days and black diarrhea). That went away, then I started having severe stomach pain and gastro issues. After those hospital visits, I went to a Gastroenterologist and had an EGD (Upper Endoscopy). He saw nothing but a red and inflamed stomach lining. Biopsies of the stomach showed no cancer or bacteria. He put me on Proton Pump Inhibitors for about 6 months. I've been to an Endocrinologist and he said my thyroid is fine.

My primary care doctor did all kinds of blood work and found nothing. A brain MRI with and without contrast showed nothing abnormal. He thinks I have Postural Orthostatic Tachycardia Syndrome (POTS) and/or Dysautonomia, a malfunction of the autonomic nervous system. We have no known cause for this.

I had an in-lab sleep study in 2018. 4.7 Apnea-Hypopnea Index, which is below the 5 AHI required for mild sleep apnea diagnosis. Yet I found another sleep doctor in May 2020 and I had another in-lab study. 64 obstructive apneas per hour were found. During the in-lab titration study for CPAP, they found that CPAP use was causing central apneas to pop up as a result of the treatment, so I've been put on a BiPap now and it has been a month. Settings are right and my AHI is now below 1 on a consistent basis so far. Still feel awful. Still have the POTS-like symptoms of blood pressure going up and down, heart rate going up and down, feeling dizzy/weak sometimes, etc.

Another thing that I've had since my younger days has always been this "pressure" that I feel in my hands and face. It will feel like my blood pressure is up or something. I seem to get the feelings in my face and hands on days when I'm really tired and I guess haven't slept all that well or I'm really behind on sleep. I had the feelings in my face and hands today and I checked my blood pressure. It is actually LOW a little bit, not high. I feel a pressure feeling in my face and hands, but my blood pressure showed 110/70 with a 72 pulse rate. Another time it showed an "irregular heartbeat" icon, which is likely the POTS-like symptoms causing it. Or maybe my body is still getting used to being so sleep deprived and I still have a lot of sleep debt.

Regardless of whatever sleep/medical issues are going on, I've clearly been checked out by everyone and my primary care doc is 100% sure that nothing is wrong with my heart or brain. The POTS-like symptoms improve when I'm doing heavy work like lifting stuff at work. It is when I'm resting that they both me the most, usually at home. But again, I have also noticed that on the BiLevel machine, when I have a good night of 7+ hours for a number of days in a row...the POTS-like symptoms and dizziness are most of the way gone or don't bother me. So I think that may be sleep-related.

Main question: what could be causing these "pressure" feelings in my face and hands? Sometimes the more physical effort I do, the pressure feeling gets stronger at both points in my face and hands. Sometimes my face will get a little pinkish or reddish if I continue doing more exercise when I'm already feeling the pressure in both. Is it just exhaustion? During the times when I feel the pressure in my hands, the veins in my forearm are very visible, but I also have larger and more muscular forearms than most people (because I've done muscle exercises previously with them directly, as well). Other times they aren't visible. But as stated, my blood pressure isn't high at the time that I'm checking it, even when I have that strong pressure feeling in my face. So I'm hesitant to say that it is high blood pressure causing it. What else could it be? I've literally had that for most of my life and at 37, nobody can tell me why. My face and hands will also feel quite warm when I feel the pressure, as well. Can anything be done about this or is it dangerous when my actual blood pressure isn't showing as high and is sometimes showing a little low?

Could I have had POTS/Dysautonomia for most of my life and simply had a breaking point when my sleep apnea got bad enough or something?
1 Responses
973741 tn?1342342773
I'm sorry you haven't gotten any answers.  I think this sounds complicated. Are you having facial flushing?  Blood pressure can contribute to that (among other things).  When have you seen your doctor last?
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