Dizziness when bp/hr are normal

[dysygirl]

I have been having some dizziness where I almost feel like I'm on a ship.  Just a feeling of movement in my head, it almost makes me nauseous. I get vertigo too but this is not vertigo.  It's more like a lightheaded wooziness. When I feel like this I check my bp and hr and they have been in normal range. I do get tachycardia, pvcs, inappropriate sinus tach which I take Propranolol for.  When I talk about my dizziness with my doctor (who is a Cardiololgist and autonomic specialist,) he refers me back to a neurologist. I have had an mri, sleep study, and balance function test. and all were normal except they did seem to find that I get get vertigo while lying on my left side but it is not an inner ear issue.  I was told it could be something to do with a deteriorating bone in my inner ear.  I will have a ct scan to look into that further.  Does anyone get dizziness without obvious causes, i.e. low bp, dehydrated, high hr, etc?  My doc seems to think my dizziness is strange but I thought it just goes with the territory of having Dysautonomia.

 

Thanks!

[StayAtHomeMom]

I say run the tests as far as the doctors are willing to. I agree with you and feel it is just part of dysautonomia but maybe you will get lucky and it isn't. Have they did a nerve conduction study yet?

[MomtoGiuliana]

I have episodes like that too (kind of  a feeling of falling/dizziness/odd head sensation--lasting only seconds at a time), during which my blood pressure and hr are in a good/normal range.  I've had a lot of testing over the years and I can only chalk it up to dysautonomia.  It can be worse prior to my period, after exercise, or if I am very tired.

[bombsh3ll]

I'm lightheaded all the time with normal HR and BP. Peripheral measurements like these have a place but are not a surrogate for either cardiac output or cerebral blood flow. I have had to (re)educate more than one specialist about the basic principles of circulatory physiology.  Two patients can have the same BP and HR but massively different levels of cardiac output as BP is a product of cardiac output and systemic vascular resistance. This is what I think the problem is with me - low CO and high SVR. You mention being on propranolol which does actually lower cardiac output and raise vascular resistance - maybe have a discussion with your cardiologist along these lines. 

I would think very carefully about having a CT in the region of your head - it is a lot of radiation for a problem I'm guessing you probably didn't have before the onset of dysautonomia. The key question is how the results would change your management, if at all. 

B x

 

[WinterSown]

I had a VEMP test last year for daily vertigo. The test is like a sonogram that maps the structure of your ear canals--it looks for imperfections that can cause dizziness and imbalance,  and also cause you to be light-headed. Vertigo isn't just the spins or a sense of motion, it also includes brain-fog and a sense of dissociation. My ears are fine and my hearing is great so they're pinning the symptoms down to dysautonomia--however they still must be treated and I work on balance at PT.  I take low-dose valium to control the symptoms when I need them, it's a muscle relaxant and helps to tone it all down quick. If you have Bonine in your bathroom cabinet you might give that a try, it can be very helpful in alleviating the symptoms, especially the wooziness. I hope you feel better soon.

 

[Mbritt724]

I get the exact same thing and it’s one of the symptoms that drove me to push for so many tests and ultimately reach my diagnosis. Can definitely relate to the frustration of not knowing the root when doctors say BP and heart rate are fine! One doctor did tell me that he thinks it could be quick drops in BP that happen and then I feel the after effects a mknjtr or so later, so my BP monitor doesn’t catch it. I have found that the days I’m the most woozy and dizzy, my bp runs a little lower than my “good” days. 

I was just diagnosed in July, so am still learning, but I’ve found that days when I don’t get enough deep rest & coming off of a day or two with a lot of activity or stress I feel the dizziness the most. Increasing my blood volume with hydration & salt ( Salt Stick pills and Drip Drop drink packets) seems to help a lot. I also find that the days when I don’t get up and do something fairly active early on (at least on the days when I feel good), I seem to have more dizziness. 

[CalicoCat]

I get dizzy with normal HR and BP and wonder if it has to do with my neck muscle tension. It can be a consequence. I also have HR related dizziness, but this other dizziness occurs separately. I also get shaky like I just had 3 double espressos, w/o HR change. I don't have a POTS dx, as my symptoms are not always present when standing; more so when moving. My GP referred me to a physiotherapist for my neck, but I haven't been yet. Wish I'd get a referral to neurologist or cardiologist, but so far only sent to internist, who wasn't that good. 

[StayAtHomeMom]

2 hours ago, CalicoCat said:

I get dizzy with normal HR and BP and wonder if it has to do with my neck muscle tension. It can be a consequence. I also have HR related dizziness, but this other dizziness occurs separately. I also get shaky like I just had 3 double espressos, w/o HR change. I don't have a POTS dx, as my symptoms are not always present when standing; more so when moving. My GP referred me to a physiotherapist for my neck, but I haven't been yet. Wish I'd get a referral to neurologist or cardiologist, but so far only sent to internist, who wasn't that good. 

Have they tested you for Inappropriate sinus tachycardia? My internist suspected that before my POTS. It sounds like you definitely need a cardiologist referral. 

[WinterSown]

On 9/18/2018 at 8:46 PM, Mbritt724 said:

I get the exact same thing and it’s one of the symptoms that drove me to push for so many tests and ultimately reach my diagnosis. Can definitely relate to the frustration of not knowing the root when doctors say BP and heart rate are fine! One doctor did tell me that he thinks it could be quick drops in BP that happen and then I feel the after effects a mknjtr or so later, so my BP monitor doesn’t catch it. I have found that the days I’m the most woozy and dizzy, my bp runs a little lower than my “good” days. 

I talked about this with my EP last week. The pressure drops are so rapid that by the time you've got a reading it's over--you are getting the recovery numbers and not the event numbers. My EP believes this happens, it's quite real and the sensations they produce are quite uncomfortable. He's been tweaking down my meds and now I am on just one BP drug in low doses but I suspect when that one is cut these drops are still going to occur. 

 

[yogini]

I had this type of dizziness which has largely gone away now.  It comes and goes every now and then but I have gone used to it I don't notice as much anymore. I think being on a beta blocker made this worse for me and it improved when I switched from a beta blocker to an SSRI.

[Pistol]

I have been caught "on tape" both passing out and having seizures. Syncope is usually caused by a sudden drop in BP ( which has been recorded shortly after an event - 80/50 ). In my case I also have been recorded having high BP after - as well as shortly before - seizure like activity ( 150/90's ). When I get episodes of extreme orthostatic intolerance I usually fluctuate really fast. So - I do believe that in many cases the BP/HR taken AFTER the episode are not accurately showing what went on DURING the episode. 

[CalicoCat]

On 9/23/2018 at 12:15 AM, StayAtHomeMom said:

Have they tested you for Inappropriate sinus tachycardia? My internist suspected that before my POTS. It sounds like you definitely need a cardiologist referral. 

No, it wasn't mentioned, but my resting HR is between 50-65. Agree on the cardiologist referral. 

[Mbritt724]

On 9/23/2018 at 11:27 AM, WinterSown said:

I talked about this with my EP last week. The pressure drops are so rapid that by the time you've got a reading it's over--you are getting the recovery numbers and not the event numbers. My EP believes this happens, it's quite real and the sensations they produce are quite uncomfortable. He's been tweaking down my meds and now I am on just one BP drug in low doses but I suspect when that one is cut these drops are still going to occur. 

 

That is SO good to know! That's what my electrophysiologist said too... have you ever worn a 24-hour BP monitor? I'd be interested to know more about what BP med you're on & how long you've been on it/if you've noticed any changes/improvement on it? 

[CalicoCat]

51 minutes ago, Mbritt724 said:

That is SO good to know! That's what my electrophysiologist said too... have you ever worn a 24-hour BP monitor? I'd be interested to know more about what BP med you're on & how long you've been on it/if you've noticed any changes/improvement on it? 

Not WinterSown, but I did 24 hr BP/HR monitoring, but the same thing happened. The device often failed to register when I was moving and my HR was peaking (per my sports watch), so I'd stand completely still, making my HR drop. I still don't know what my BP does when my HR peaks. 

[Mbritt724]

7 hours ago, CalicoCat said:

Not WinterSown, but I did 24 hr BP/HR monitoring, but the same thing happened. The device often failed to register when I was moving and my HR was peaking (per my sports watch), so I'd stand completely still, making my HR drop. I still don't know what my BP does when my HR peaks. 

Very interesting. Did the heart rate monitor pick up anything? I wore two different types this summer, an event monitor (which I would have to push to activate when feeling weird... dumb in my opinion because i couldn’t predict when I would suddenly feel weird) & a second carnation ambulatory 24-7 one for 7 days. My Apple Watch will register having low heart rates but the electrophysiologist said the heart rate monitor never dropped lower than 58 bpm... so I’m just curious if yours picked anything up?

[CalicoCat]

I should have said BP monitor that also measures HR. It wasn't a holter. It malfunctioned at most of the peaks I had, since my peaks occur mostly when moving. My HRM gave a much better picture, but the internist dismissed it completely and went with the HR data from the malfunctioning device. 

7 hours ago, Mbritt724 said:

Very interesting. Did the heart rate monitor pick up anything? I wore two different types this summer, an event monitor (which I would have to push to activate when feeling weird... dumb in my opinion because i couldn’t predict when I would suddenly feel weird) & a second carnation ambulatory 24-7 one for 7 days. My Apple Watch will register having low heart rates but the electrophysiologist said the heart rate monitor never dropped lower than 58 bpm... so I’m just curious if yours picked anything up?

[Pistol]

@CalicoCat - you said the device malfunctioned whenever your HR went up. It is possible that it could not read a BP when this happened because it was too low. Even BP monitors in hospitals say error message when the BP is too low to detect. That in turn would also cause your HR to go up. 

[CalicoCat]

16 minutes ago, Pistol said:

@CalicoCat - you said the device malfunctioned whenever your HR went up. It is possible that it could not read a BP when this happened because it was too low. Even BP monitors in hospitals say error message when the BP is too low to detect. That in turn would also cause your HR to go up. 

I don't know. I never faint and often feel more lightheaded when HR peaks, than dizzy. The worst dizziness is when HR is normal and something else is going on (neck issues?). I tried measuring BP at home with my own monitor, not easy as I don't peak as much when standing still. BP does seem normal when HR Is high.

[Mbritt724]

Kind of along these lines with quick BPswings that are undetectable, does anyone else get clammy hands/feet and feel hot during low blood pressure drops or days the BP is running lower?

[Pistol]

Yes - I have both hyper-and hypotension. When my BP is low I become clammy, strong heart beat, weak, feeling hot or flushed. This is very different from when I have high BP - chest pain, cold hands/feet, chills, tremors. This can change from minute to minute. 

[Mbritt724]

1 hour ago, Pistol said:

Yes - I have both hyper-and hypotension. When my BP is low I become clammy, strong heart beat, weak, feeling hot or flushed. This is very different from when I have high BP - chest pain, cold hands/feet, chills, tremors. This can change from minute to minute. 

Thank you for responding  so far, they’ve only diagnosed me with hypotension, but I think the hyper may be a possibility too (just not diagnosed yet) because I definitely have those symptoms too.

[StayAtHomeMom]

3 hours ago, Mbritt724 said:

Thank you for responding  so far, they’ve only diagnosed me with hypotension, but I think the hyper may be a possibility too (just not diagnosed yet) because I definitely have those symptoms too.

Has your thyroid been checked?

[Mbritt724]

On 9/28/2018 at 11:05 PM, StayAtHomeMom said:

Has your thyroid been checked?

Yes, I’ve had hypothyroidism for about ten years... started when I was 17. 

[StayAtHomeMom]

4 hours ago, Mbritt724 said:

Yes, I’ve had hypothyroidism for about ten years... started when I was 17. 

Hypothyroid or Hashi's?

[Mbritt724]

2 hours ago, StayAtHomeMom said:

Hypothyroid or Hashi's?

Hypo, never hashis. Thyroid was the first thing I thought was going on when all of this started... but all is fine on that front as of now!