Low Flow TIA caused by hot water immersion

[jwillie]

I have low blood pressure usually 96/59 or sometimes more sometimes less, but I also have MVP and minor AVS.
After being put on Atenolol for arrhythmias my lip on the right side of my face would go numb when sitting in bathtub or jacuzzi.  I never thought anything of it, but then they upped my dose because the arrhythmias started again.  So, the first time I sat in the bathtub after being on the 50mg of Atenolol my lip went numb on right side again, and then it went up my cheek, into my eye and up into my head, the right side only.  I immediately got out and my foot was numb, I almost fell over.  
I read that hot water can lower blood pressure by 20 on diastolic and systolic causing Low Flow Tia.  Is this possible?
My cardiologist said it was all in my head, but it happens every time I am in a tub or jacuzzi.  Needless to say I have not gone in hot water since then.  I wanted to try it and check my blood pressure while in the hot water, but figured that could be dangerous.  
Please let me know what you think.  I like your opinions and advice.
Thank you very much.  I wasn't sure if I should see a neurologist.  Also, the hot weather really wears me out while being on such a high dose of Atenolol.  I am only on it to regulate my heart beats, but with low blood pressure already, being on a beta blocker seems to be a bad idea to me.  

[jwillie]

I have low blood pressure, my HDL is 57, Tric 38 and LDL 101
I do not smoke or have diabetes.  So, with a normal blood pressure of 95/60 and the only time I get the face numbing is when I sit in hot water, how can it be anxiety?  
I am in the process of finding a new doctor, he actually said to me "the aortic valve is not part of the circulatory system" so I don't want him as a doctor anymore.  That wasn't real bright.
I have read that sitting in a jacuzzi can drop your bp by 20, and a 75/40 would cause a low flow TIA even without a stenotic carotid, wouldn't it?  It has never happened to me any other time besides sitting in hot water.
I am on blood pressure lowering medication when I don't have high blood pressure, it is for heart beat regulation only.  Please ask questions that might be more pertinent to this to help you with this.  
I am asking your opinion only so that I know how to approach a doctor regarding this, I am not using this as a diagnosis.  But it seems to me and my brother, whom is a nurse that there should be a better way to regulate my heart beat without being on a blood pressure medication that I don't need.  I actually have to eat more sodium on some days because I get so dizzy, low blood pressure *****, and the atenolol doesn't help.  I get extremely warn out in warm weather quickly.  

[Christopher R Newey, DO]

Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with a doctor.

Without the ability to examine and obtain a history, I can not tell you what the exact cause of the symptoms is. However I will try to provide you with some useful information.

Your symptoms could be anxiety related; however, the unilateral aspect of it is concerning for a vascular etiology, such as carotid stenosis. Carotid stenosis is the narrowing of one of the major arteries supplying blood to the brain. The cause is typically atherosclerosis. The risk factors include high blood pressure, high cholesterol, diabetes, and smoking. Carotid stenosis can be symptomatic or asymptomatic. Some patients with symptomatic carotid stenosis will describe episodes of visual changes, sensory changes or weakness, to name a few. Also, if blood pressure is dropped, some patients may have symptoms. The diagnosis is determined by various imaging techniques, most commonly by ultrasound.

I would suggest that you discuss with your physician if they think an ultrasound is indicated.

Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.