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Weak Pulse When Lying Down


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Hi everyone. I'm new to the forums, and though I don't have an official diagnosis, I'm pretty sure I have some kind of dysautonomia. I've seen a few doctors and it seems like nearly everything else that matches my symptoms has been ruled out.

A couple nights ago I had a very frightening experience. I noticed that my pulse was feeling slow and weak (I can feel it most of the time) and my hands were looking grayer than normal, so I checked it and it was around 50. I decided to get up and move a little, but even with standing and walking around the house it didn't get above maybe 55, and moving was making me light-headed, so I sat back down.

A few minutes later I got in bed. Lying there, I started to feel even worse. I checked my pulse at the neck and over the course of a minute or so it got weaker and finally disappeared, and everything began to go black. I sat up right away and my heart rate went way up, but my pulse was still really weak, and every time I laid down again the same thing would happen.

Basically at this point, I'm worried that lying down is somehow reducing the flow of blood to my head, and that this is going to happen while I'm sleeping or something and kill me. Has anyone else had a similar experience and lived to tell the tale? Any idea what might be causing this?

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Have you gone to your doctor yet and reported this?

I'm wondering if you may be a candidate for a pacemaker?

I worked with an older woman who's pulse was slowing down and stopping at night. But she is

Hers was in the 40's.

Sleeping with head up might help.

I am a worrier I would have probably went to the hospital if that happened to me.

My heart feels like it slows down and gets weak but I've never gone that low.

And I have had the feeling it stops all together usually when mine does that it then takes off like a race horse.

The nurse who got the pacemaker says she is feeling better than ever.

I don't think she has dysautonomia that I know of but she is retirement age and still working like a trooper.

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I agree with lieze...go to the ER if it gets that low and you pass out. But I do have a few questions/suggestions: were you doing anything at all that would stimulate your vagal nerve at the time(such as bearing down or holding your breath)? Also, when you checked your carotid in your neck, did you check one side at a time or both simultaneously? You should never check both at the same time b/c you can cut off the blood supply to your brain (temporarily, of course). You should also avoid "fooling" with your carotids too much b/c you could inadvertantly do a "carotid massage" which causes bradycardia. It is important to note that when you check a pulse and you put too much pressure, you could actually occlude the vessel and thus lose the pulse altogether. This is important b/c it can make you very anxious. However, if you felt as though you'd black out, it isn't likely that you occluded the pulse yourself. I hope you get much better and make sure to let your doctor know that this is happening. Have you had a 24 or 48 hour holter monitor or maybe even a 30 day event recorder?

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Hi all and thanks for your responses :-)

I was checking my pulse on the left side only, and I believe lightly enough to prevent problems. I can't think of anything in particular I was doing that would have caused a vagal response. I'm pretty sure I wasn't holding my breath at any rate. My stomach was probably full (I've been having problems with it not emptying properly), so that may have been an issue.

I haven't had a holter or event recorder. I had ekg/echo/stress several months ago, which were relatively normal at the time. I have a neurologist appointment this Thursday and I'll talk to him about it, but I'm not sure how helpful he'll be.

I'm the same as both of you, my inclination is to go the E.R when something like this happens. Unfortunately, the E.R. is obscenely expensive, even with insurance, and I've been twice in the past 6 months already to no avail. Some members of my family don't think there is anything really wrong with me, and I'm sure another visit would prove very unpopular.

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MattT,

I completely understand the "family situation". You'd think my family would listen to me since I'm a nurse but even my mom still thinks I'm "thinking" myself sick. I keep telling her that I'm not sick b/c I'm crazy but rather I'm crazy b/c I'm sick. I even wore my Dysautonomia Awareness T-shrit form this website on Christmas day to "educate" her...LOL!

Note about the ER: my doc has advised me to stay away from them b/c the medical community is generally not aware of dysautonomia or how to treat us properly. He feels that the ER docs (& sometimes unfamiliar GPs) will mess us up. Therefore, I have an emergency plan of taking some of my medication regimen. But, having said that, the nurse in me comes out and any time something happens that is new or severe...I usually advise seeking medical treatment. You should decide based on how you are feeling. Don't let money or what others think deter you if possible. It sounds like you will be taking the right step by at least letting your Neuro know. If he can't help, go to a cardiologist and make sure there isn't anything going on with your SA node (the primary natural pacemaker of the heart).

Hope you start feeling better immediately!

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Thanks for your well wishes!

That may be the best option in the end. I've thought of possible SA node issues, though I'm not sure if that's the problem. Even though 50bpm is low, it shouldn't be causing fainting, yea? It never got any slower than that, even when lying down, just weaker. But of course there's no way to know without having it checked properly. Normally I'm between 60 and 80 at rest.

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Well, the SA node has an intrinsic rate of 60-100 so if it's below that, it makes me suspect SA node issues (maybe a block or something but I'm not sure). And I would think that too low a heart rate would cause hypoperfusion to the brain (which many here experience) so maybe it could cause loss of consciousness...? Honestly, the condition that we are all battling baffles me. It seems so complicated and intertwined and we are all different in how we react to things which makes it difficult for doctors I'm sure. Hang in there and visit this site often as I find the posters here very helpful.

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With my AVNRT which was an extra pathway in the heart it was explained to me that it could do one of two things-slow the heart down or speed it up.

I was having both type episodes.

I was told it's harmless but there is no way to know that for sure with you until you get checked out.

You need to see a cardiologist and maybe wear a monitor and see if they can catch this and get an idea of what is happening.

I think that might be the first step for you unless by chance you are symptomatic when you do visit your doctor.

To find an abrnormal pathway they have to do an electophysiology study of the heart.

It could be if they see your heart is just beating too slowly they would just recommend a pacemaker and you wouldn't need the electrophysiology study of the heart.

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