Sudden Drop In Blood Pressure And No Change In Heart Rate?

[Detrick7]

Does anyone with NCS or anything else experience a sudden drop in blood pressure but no change in heart rate during episode? I get epsiodes where I get light headed, tremors/weird muscle movements, etc. etc. typically after a yawn; big long yawns (I am not tired). One trigger is standing up quickly, but get many when sitting at work and on the computer. I was diagnosed with NCS, but the only test that has shown anything was a 24 EEG, when I had an episode I had weird EEG readings the neurologist believes is a drop in blood pressure, but no change in heart rate. I have had a regular EEG, sleep deprived EEG, ttt test, MRI, hearing tests, other ear tests, sleep study, heart monitor for a month, and pretty much every other heart test. These were all normal. All normal.

Part of the definition posted on DINET for NCS is "this disorder is characterized by an episodic fall in blood pressure and/or heart rate that results in fainting (Robertson, 2002). " I read this to believe I can have NCS even though the heart rate doesn't change. However, my neurologist, who at first didn't believe it was seizure related is starting to think it may be. He thinks this because my EEG that showed abnormal brain activity showed no changes in heart rate. Some people who have witnessed my episodes say they look like seizures, but that doesn't they are seizures. Drop im blood pressure can cause moverments that just look like seizures. I have tried 2 different SSRI, midodrine, and 2 seizures medications with limited to no benefits. Only one I am still on is generic Zoloft (SSRI). This seems to help me recover faster from episodes, but definitely doesn't prevent them. I don't know what to think anymore. I do tons of research on my own and go back and forth between thinking I have NCS (or some other form of dysautonomia) and some form of seizure disorder.

My basic question is does anyone have no drop or increase in heart rate during episodes?

Thanks for your input,

Lance

[dianne.fraser]

Lance - I was diagnosed with cardioneurogenic syncopy two years ago based on the post-exercise collapse of my blood pressure while my heart rate stayed perfectly stable (it was captured using one of those new-fangled blood pressure cuffs that record blood pressure and heart rate). I'd had investigations before (all normal except for lots of ectopic beats) including two holter monitors which showed no change in my heart rate when I collapsed.

If you want to confirm whether your blood pressure is dropping while your heart rate stays stable, perhaps you could buy a blood pressure cuff or borrow one from your GP, bring on an episode and take readings every couple of minutes.

I wasn't sure about my cardiologist's diagnosis, but I'm certain that I have some form of dysautonomia. Knowing this, I've been able to learn to manage my illness.

I only collapse post-exercise (so I'm fairly sure that my blood pressure is otherwise stable). My heart rate is sometimes very irregular, however, and I also spike reasonably high heart-rates that can take many hours to settle (after which my dysautonomia symptoms are much more severe for several days).

Not exercising has eliminated the collapse and, along with a lot of other measures, stablised my illness. As long as I'm intensively managing my dysautonomia generally, most of my symptoms sleep. I didn't tolerate any of the daily medication options on offer - I tried beta blockers (Inderal and Minax), SSRIs (Arapax and Lexapro) and an SNRI (Pristiq).

I've found dysautonomia easier to manage when I eliminate everything that triggers or aggravates my illness and when I take measures that soothe it. This awareness has been far more effective than any medication in getting my illness under control and in maximising my functioning.

I understand that minor seizures can be a feature of dysautonomia. During an 18 month period when my illness wasn't well controlled I had a number of small seizures - for a few seconds at a time, everthing in my field of vision would quiver (at first I thought my eyes were quivering....).

Good luck and best wishes

Dianne

[Jacquie802]

I'm also experiencing a drop in blood pressure without a change in heart rate. Have you found any answers?

[targs66]

I also get the drop in BP without a corresponding rise in heart rate. I was diagnosed with neurally mediated hypotension based on a TTT, which also eliminated POTS as a diagnosis (since my HR doesn't go up to compensate for low BP). My understanding is that NMH is just about the same thing as neuro cardiogenic syncope (NCS), but if anyone knows more about this please pipe up!

Obviously, it's difficult to monitor this because you can't anticipate the BP fluctuations. However, I find that some times that my BP is in normal-ish range (97/68, say, which is high for me), if I take it immediately after that, it might have dropped to, say, 88/58. My heart rate seems to stay the same - usually around 70 - 72 bpm. I think it's why I feel lightheaded and spacey so much of the time!