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Postural Hypotension

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Hello everyone,

I’ve stumped ALL of my doctors so I thought to ask the group. Does anyone develop or do you know anyone that develops hypotension ONLY when lying in the right or left lateral position? Every time I lie down on my right or left side my blood pressure tanks. I first noticed it sleeping because it woke me up. I thought I was going to faint. No doc can explain this or offer a theory. Does anyone have any thoughts? 

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Directly from the summary page. 

Among the causative mechanisms which may bear some relation to the phenomenon of left lateral. hypotension, a twist of the heart's pedicle at its entrance into the pericardium would be a factor if certain conditions prevail. 'The pericardium itself may be affected by the movements of the heart: Vagovagal reflexes of the type known to produce fall in blood pressure and shock would more readily occur in diseased and hypersensitive hearts. The resulting hypotension, reducing the coronary circulation significantly, would then explain the frequent appearance of anginal pain and dyspnea in patients with confirmed or suspected coronary disease whenever they rest on their left side.

Other vagal reflexes will also have to be considered, especially reflexes produced by distention due to positional effects of an abdominal viscus, or by stimulation of the pressor-receptors in the aorta, pulmonary artery, and the carotid sinus. In addi-tion, changes in the intrathoracic pressure, in the venous return, and in ventilatory and respiratory, as well as in neuroregulatory, factors and the element of vascular reactivity may play essential roles in creating a tendency to left lateral hypotension.

Various considerations, for instance, the fact that most persons respond to the left lateral recumbency with an immediate fall (more or less pronounced) in both systolic and diastolic blood pressure, make any interpretation difficult, if it is based on the assumption of a single cause. A restriction or obstruction of the circulation at any point would not inrediately reduce the diastolic pressure. It appears that not one single causative factor, but rather a concatenation or combination of factors takes effect in the production of left lateral hypotension and its serious complications.

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