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Pots And Bradycardia


Iheartfrogs217

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Hi frogs :)

I think that for some us it does seem to be part of our mixed up autonomic nervous system. My resting heart rate has dropped lower (averages around 48-52) since Pots and at times it drops into the low 40's. That is also without any medications that would lower it. My internist is unconcerned about my resting rates and says that some people just tend to have lower heart rates. I do plan to discuss it with my EP/cardiologist when I see her next, just to make sure she is of the same opinion. I think it's worth discussing with your doc, since he/she knows your medical situation.

Are you having symptoms when your heart rate goes that low? I feel awful (weak, lethargic, hard to even hold my head up) when my heart rate is that low.

It might be helpful for you to keep track of that info, (what you were doing at the time, how you felt, what the rates were, how long did it last, etc) if you aren't already, to show to your doc.

Sorry you are experiencing this - I know it can be scary.

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Hi peace!

Thanks for all of the great information! It's a lot more comforting to know that someone else experiences this too! Yes, I do experience chest tightness and sometime shortness of breath. Sometimes it feels like I can't get my heart rate higher, however it usually goes up if I walk upstairs or something. Please let me know how your appointment goes at your cardiologist and what they suggest! Thanks again for your advice!! :) I'm also sorry you have to go through this too! I hope your cardiologist can give you some great answers. Talk to you soon!

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I wish I knew if it was DA related. Ive always concluded it was POTS itself since that implies out of control cardiac upswings right? But with

disregulated autonomic, Ive read here and there that it could be a less likely symptom.

Ive struggled with it since i got sick, but didnt pay much attention before so i dont know the numbers. I DO know that one night in the ER they had to speed up my HR. Im VERY careful about hydration and heat. And yes i think the klonopin i use that helps with my dysautonomia slows it down some depending on how much had to use that day. Some days almost none, other days up to 2 or 3 mg.

I have all the other classic symptoms of DA INCLUDING palpitations, an increasing systolic bp during triggers, heat intolerance, dizzy, weak,

nauseaous, various neuromuscular issues, blood pooling, sudden onset allergies, heart PVC's, etc. etc.

I tend toward a slow heartbeat but it can get WORSE and then i can trigger into something more scary as you said. I keep potassium on hand high strength fro Dr., salt, power ade zero, etc for when the symptoms come.

Exposure to excitotoxins such as MSG and aspartame make it MUCH worse. I Avoid those.

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It happens a lot with me, low heart rate, high pulse pressure, therefore thumping palpitations. I've been told repeatedly by some of the best POTS docs (keep in mind I have benign ECG and Holter results) that it's no big deal. However now that I switched to nadolol from propranolol, I'm not having any issues.

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It's not uncommon for me to have hr's in the 40's if I get up an move around it bumps right back up.

I have had episodes where my hr plummeted and my blood pressure got very high. I felt a horrible sense of "doom" the first time it happened I just made myself go to bed. The second time I went to the er. I had low sodium which may or may not have been irrelevant. Nowadays I'm much more careful about keeping up my salt intake.

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Thanks for all of the great information everyone! From what everyone has said it just seems like bradycardia is another annoying POTS symptom. It's brought me lots of concern that it's not just POTS, but it's very comforting to know that other people have experienced this at one point of another. It also concerned me because I'm not on any medications that would cause it. I was also very scared that I would have to get a pacemaker at 16! Does anyone else with this problem have a pacemaker or is that a bad idea to get one with POTS? Thanks again for all of your help. I truly appreciate it!

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My mom has a pacemaker so I know a little about them. She does not have pots but her heart was stopping for 7 seconds or so at a time. She is doing great and back to running circles around me.

It is not recommended for POTS (but sometimes coexisting conditions).

Essentially pots (for me anyway) is a neurological problem- not a heart problem. My understanding is that pots people with pacemakers may feel better for a year or so- but end up back where they started and pacemaker dependent.

I see a really good EP and have my appointment with her next week. I'm going to ask about my bradycardia- she hasn't worried about it in the past. If I learn anything new that might be relevant I will absolutely post the information.

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  • 3 years later...

Went to ER  to have my knee examined 1 day after I fell during a sudden bad faint with vomiting and bowel loosening. I'd never had the nausea like that before. And the whole episode came on so fast!But I'd been outside for several hours. Not doing anything strenuous but potting flowers. While @ ER my hr was in 40,s and bp steadily rose  to 225/115. Just laying there! Why? They finally gave me 2 doses of hydralazine and sent me home, upping my amlodipine from 2.5 to 10mg and stopping metaprolol. When I asked why I fainted (bp or hr) they said my hr probably dropped suddenly.  My cardiac PA said POTS is like that and said she didnt like taking me off the bb, but that only during the ttt did my hr jump severely so just watch and see. And see you in a year! I guess I'll just be my own doc.I found that 10 mg of amlodipine (Norvasc) was too much and am back to taking 5 mg as I've done for years. I've felt quite depressed since then. Thats 2 serious injuries in 1 year from fainting. The first broke my back. The knee is better.  The **** with docs. Other than getting refills, and only because not doing anything would leave me feeling hopeless, I dont believe them and could care less about wasting my time going to them. Whats the point if they just don't even try something else?

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Hi Milliesgirl. Sorry you are going through this. In my opinion, you don't have the right doctor. Mine sees me every 12 weeks and is very concerned about fainting, especially fainting with injuries. He may not know exactly which way to go because there is no new treatment to try and he may ask me to keep a diary of symptoms and BP, so he can see what is happening, but he would never just say, "see you in a year."

Can you get a second oinion? Even though doctors diagnose POTS, it doesn't mean they think it is important enough to take seriously and treat proactively. Unfortunately that was my experience. 

I hope you are able to find better help. It is out there.

Kim 

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Kim, thanks for the support! Ive asked the PA if I need a further testing to determine whats causing it but she said no bev3ause and shes worked with POTS for 20 years. Ive had lots of imaging tests but not the norepinephrine test. Though I had a MRi to rule out adrenal tumors several years ago when I had an episode in my former GP's office. I'll never forget it. He kept telling me that what was happening was Real and not in my head. But my (late)hubby was ticked because it was supposed to be HIS  appt. Maybe its memories like this that anger me. , But probably, the adrenaline from being furious with him during an episode has saved me many times too. Literally experienced abusive neglect so many times, so take my complaints with a grain of salt...oh, no pun intended lol! I will seek out someone else (doc not husband ?)

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Guest ANCY

Milliesgirl- so sorry things are so difficult for you. You will be in my praters, and that you find the dr that will help you the most. It can be so hard facing medical hardships and unknowns, only compounded by not having the support of your medical team. I agree with Kim, could you get a second opinion? I'm currently in process of getting a second opinion for my osteomyelitis because it seems my current one has given up on trying to solve the problem. Keeping a journal has been very insightful for my Drs as well, more of a long term picture unlike the 30 minutes you spend in the office. 

I feel for you with the syncope and consequent injuries... I've passed out 5 times today, last Monday passed out and fell out of my wheelchair, not good for back pain that's for sure! Is your knee ok now? The worst injury I have sustained (my family and I are careful to avoid "uncontrolled descents") is a concussion last year which led to developing persistent severe bradycardia. They put a pacemaker in a month later when my avg hr went down to the 20s and wouldn't exceed 40 even with moving around in PT.  Pacemaker was life changing for me, if you want last year I posted more about that. It not only brought my heart rate up but assists when my bp is dropping by raising my heart rate to compensate. I went several months without passing out, then developed other crisis and my body couldn't cope with it all and started passing out again.

Wishing you all the best and hope you find what works for you!

 

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  • 3 weeks later...

In 2009 I developed chest pain while experiencing a stressful day at work. In the Er my heart rate sitting in the stretcher was 42 and the alarms were going off and I felt fine.And all the tests were negative. And all thr workup was neg too

Debbie

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I have been relatively stable for about 10-12 years with meds for POTS. However in this past 6 mos, I've experienced some bradycardia 40-49 but and sometimes systolic BP 97-101. Via phone I was told to eat more salt. That did help systolic BP rise, and perhaps has helped pulse rate rise a little. I've been on Metoprolol ER 50mg for about 10 years with no dosage changes. I see POTS doc again around Nov 2017, so will see what he says at that time.

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Hi all, my heart beat can bottom out now as lve hadots since l was just 13 years old. Its become so low ( lowest measured was 26 bpm) that l start to go grey, have problems getting breath, go stone cold and start to cold sweat....followed by .....black out . Standing up, sitting down, in bed it doesnt matter when, where or at what point in my day when it hits its dam horrible.

My Pots man cant understand it my hearts doing crazy fast then bang slow, lve recently had a very bad session in my G.P.s off ice ( scared him white ....999 / 911 call) and  so many tests. Its not drugs so lm a bit of a mystery.

Look if it gets worse dont be afraid to go to your G.P.  or consultant and ask questions , having a very low heart beats not fun, do you go cold and sweat as well? If so tell them its important.

Take care Ami .

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