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~Naomi~

Pulse Pressure

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I've made a definite connection between narrow pulse pressure and feeling really awful. This morning I bent over to pick something up - got upright and felt all those bad feelings (rapid heart, dizzy etc.), took BP while it was happening and heart rate was 147, BP 92/77 - pulse pressure would be 15 right? I've tracked this several times now, so I know there's a relationship. Just don't know what it means, lol. How does this relate to POTS again?

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From WIkipedia:

Low (Narrow) Pulse Pressure

A pulse pressure is considered abnormally low if it is less than 25% of the systolic value. The most common cause of a low (narrow) pulse pressure is a drop in left ventricular stroke volume. In trauma a low or narrow pulse pressure suggests significant blood loss (insufficient preload leading to reduced cardiac output).[4]

If the pulse pressure is extremely low, i.e. 25 mmHg or less, the cause may be low stroke volume, as in Congestive Heart Failure and/or shock.

A narrow pulse pressure is also caused by aortic stenosis and cardiac tamponade.

So I'm thinking because we usually have blood pooling in our lower extremities, our pulse pressure drops because there is less blood volume being pumped through our heart (similar to having blood loss).

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There have been past posts on this, but a narrow pulse pressure in a POTS patients may not be blood loss from trauma. But from hypovolemia, or at least thoracic hypovolemia. Many of us on the forum have this.

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a narrow pulse pressure in a POTS patients may not be blood loss from trauma. But from hypovolemia, or at least thoracic hypovolemia.

"Thoracic hypovolemia" meaning less blood in the chest?... because of the pooling in the legs? And what does this mean --> "The most common cause of a low (narrow) pulse pressure is a drop in left ventricular stroke volume." As long as I've been at this, I still don't get most of what is going on!

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Naomi- The left ventricle of the heart is the one that pumps oxygenated blood out to the rest of the body and brain. Left Ventricular Stroke Volume refers to how much blood the left ventricle pumps out. The "stroke volume" can be decreased because of overall low fluid volume, etc.

I hear you about the not "getting most of what is going on." Seems like a bad joke to give us brain fog and then expect us to try to figure out what is wrong with us AND possibly, what the mechanism of it all is. LOL

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I also get this Naomi, especially in the morning. My pulse pressure widens as the day goes on. I believe, atleast for me personally, that it is not caused by essential hypovolemia but instead by blood pooling in the legs as a previous poster noted. My pulse pressure widens significantly when I lay down because the blood is reaching my heart better. If it were from essential hypovolemia it would stay narrow.

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I should have added that to Julie, mine only narrows when I stand. When I lay down it's back to normal. I wonder if these new studies that show dysautonomia patients with essential hypovolemia looked at pulse pressure. Do these patients have it all the time or only when standing?

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My guess is there is something amiss with the muscrinic recpetors with the vessels- they are de-sensitized and want to dialate when they are supposed to constrict? I'm hoping the Mayo can give me an answer in January :)

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i have narrow pp standing and sitting. haven't tried lying (yet). my ans doc wasn't too worried about it, will see my cardio in january and will ask his opinion. he told me some years ago that i have low pressure in my left heart chamber which seems to be classical for pots. octreotide makes me pool much less but i still have the narrow pp.

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thought Id bump this...wish I hadnt made a redundant thread before seeing this..lol

so this seems to be common and is why I feel so crumby. One thing with me is narrow pp stays narrow even lying down, could this red flag the hypovelemia issue?? I worry that my hearts not functioning properly because of structure but I hope its just lack of supply.

Has anyone found anything that helps widen it?

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