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Heart issue - can diastolic and systolic be too close, what do I do?


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Can your pulse pressure be too low? Mine sometimes can be less than 20 between the two readings . . . I am really worried. I am 33 with four amazing girls who I need to be here for. The last month I have had big issues with palpitations, exhaustion, high Bp, tight chest etc. The doctors have said it's a mix of a previously diagnosed svt and high stress response due to a traumatic event that happened at the same time. . . But I have felt so unwell I am worried. I have had some bloods and ecgs. I am just worried they are missing something and the close readings is a problem? Thank you in advance.

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    @Ksheo- I am sorry you aren't feeling well! I am not sure if readings can be too close, but I do know that things can be missed on ECGs and blood work. Your symptoms are a little concerning, so you might want to find a doctor who will order an echocardiogram. That way you can know for sure that everything is okay. You are the patient, and patients know their bodies better than any doctor, so if you think that it is not cause by stress or the SVT, then you should definitely find someone who will help you.  Good luck, and feel better soon!

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2 hours ago, Ksheo said:

Can your pulse pressure be too low? Mine sometimes can be less than 20 between the two readings .

Yes, the “normal” range is between 40 and 60 but low pulse pressure can be common among those of us with dysautonomia. On my tilt table test my pulse pressure went down to 8 and they stopped the test. It is definitely something to discuss with your autonomic specialist or cardiologist/electrophysiologist.

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12 hours ago, Ksheo said:

The doctors have said it's a mix of a previously diagnosed svt and high stress response due to a traumatic event that happened at the same time. . .

@Ksheo - I am so sorry that you are dealing with these symptoms. Stress is a known and common trigger for flares like yours. SVT is not dysautonomia and should be treated separately, and I am not sure that it would cause your symptoms. 

I know what it is like to have POTS and care for children 😣... yet the only remedy I know helped me is ample REST and IV fluids. I do not know what country you live in but here in the US IV fluids are used in certain cases to stop a flare. Since you experience high BP some docs may be hesitant to use IV fluids but for me they LOWER my BP immediately. I have been hospitalized with a flare such as yours often in the past and every time IV fluids brought me back to the living, despite very high BP. --- It is difficult to get rest with kids to take care of - but it is necessary to overcome a flare. Do you have anyone to help you? It may be a good idea to ask for help with them and use the time to rest, many have ended up in bed for extended times because they were not able to rest during a flare. ---- Also - it is important to increase your fluid intake and wear compression stockings, avoid prolonged periods of being upright and maybe your meds need to be increased or changed during this time. But again - the single most effective thing is REST!

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Low pulse pressure is pretty common in people with dysautonomia but I'm not sure if you've been diagnosed with that as well as SVT.  Is your HR very high when your pulse pressure is low?  I think very high heart rates can cause low pulse pressure but I'd definitely mention it to a cardiologist

I have hEDs and POTS and lying down my pulse pressure is fairly normal (around 40) with my BP 100/60 but when I'm standing it is never more than 25 - it is usually around 20 with my BP 100/80 but when I'm in a POTS flare it will be more like 15 and I've seen it as low as 12 with my BP either low systolic (80/65) or high diastolic (125/110).  My cardiologist said it's just a sign that there is not enough blood for my heart to pump round my body when I'm upright cos it's all stuck in my feet thanks to my stretchy EDS veins!  The lower my pulse pressure is the worse I feel so I do really sympathise with you.  Pistol is right though - the only thing that really helps me is reducing activity in a flare and trying not to panic - after 20 years I've finally learned that getting upset and worried about how awful I feel only makes it last longer...

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Hi @Ksheo,

I wish I had helpful advice but I just wanted to let you know I often have a very narrow pulse pressure.

I've had many times where it was been 20 points difference (or less). A reading such as 80/60 or 70/50. I always feel very unwell during those episodes, but no doctor or specialist has really ever been able to explain why it happens, other than it being the dysautonomia.

Also have had times where I've had a wide pulse pressure (although far less common for me).

Dysautonomia really is a wild ride!

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