Why I Think My Bp Goes Up Whenever I Talk...

[janiedelite]

One of my most debilitating symptoms is the increase in chest pain, flushing, and also increase in BP while talking. I also experience headaches, increased brain fog, and burning skin on my upper body while talking which can last for minutes, hours, or days if I've had a bad episode. I've been thinking about the mechanisms behind this. At Mayo, I demonstrated an excessive phase 4 overshoot during the Valsalva (which is fairly common for POTS patients). During phases 1 and 2, you're blowing into a tube against resistance which increases intrathoracic pressure which pushes in the inferior vena cava decreasing blood flow back to the heart and upper body. In phase 3, the pressure is released which usually causes a drop in BP (mine didn't drop much, though). However, for those of us who have an intact sympathetic nervous system, our body's normal response to the drop in BP is to vasoconstrict and try to get blood flowing back to our brains. This causes a normal rise in BP during the last phase (phase 4) of the Valsalva. I was told that my phase 4 response was excessive. My BP went over 240/130 during phase 4.

So I've been thinking about what we have to physically do in order to talk. We take in a breath and sustain it over a period of time while we are getting out our words. It's kind of like a milder valsalva maneuver, except we're doing it all day long. I'm thinking that if I have a tendency for a hyperadrenergic response to my pooling, it's normal for me to have excessive peripheral vasoconstriction in response to fluctuations in intrathoracic pressure.

It also makes sense that stress makes my tendency for these problems while talking even worse. Stress would increase my hyperadrenergic response altogether, including the response to changes in intrathoracic pressure.

Thoughts for those of you who obsess about these things also?

[ramakentesh]

I find that stressful situations make my symptoms worse. Im not sure why this is. NET deficiency? Im not really sure. In crowded environments I sometimes find I feel worse just to feeling overstimulated. its fairly common to report this.