Is my screwy blood pressure/heartrate worrying?

August 16, 2016 1:10 AM

People of MeFi, I need some advice. Recently – the last week or so I've really noticed and started tracking it, but probably longer than that overall – I've noticed that my blood pressure and bpm have been acting a bit crazy.

I've always had lowish blood pressure (like 110/70, that sort of area) and a very low resting bpm (50-60, max). That's normal for me. However, I've noticed recently that I've been very dizzy and breathless a lot, and getting very woozy and head-rushy when I stand up, or if I stand for too long. I've also had the sensation of my heart pounding pretty violently, more or less at random. I started checking my bpm at intervals through the day, and for the last couple of days I've got readings from 45 to 140, although those are extremes and it usually seems to be somewhere in the 80s or 90s. So not outside the acceptable range, but not normal for me, and I've been feeling pretty unwell with it. The high readings also don't seem to be associated with being unusually active – it does get higher when I stand up & move around as you'd expect, but it also does it randomly. I did see a doctor about the dizziness about a week ago, and she checked my blood pressure, which was low even for me (106/58, I think), but didn't seem concerned. So my question is, should I go back? Do I need to be pushing for this to be checked out? Background details – I've always been physically really healthy up until about a year ago, when I started having a lot of problems with joint pain and fatigue. I've had a bunch of other fun symptoms since, and I'm currently signed off work and waiting for a referral to a rheumatologist. I'm pretty much housebound at the moment due to pain, fatigue, muscle weakness and general unsteadiness. I'm also losing a lot of weight, very rapidly, despite being less physically active than I've ever been in my life until a month ago. I had a bunch of blood tests which came back pretty normal, no scary autoimmune stuff or anything The current favourite guess seems to be CFS/ME or something similar, but right now I have no idea what's going on with me, and I seem to be getting worse rather than better pretty rapidly. I do know that blood pressure problems can be part of CFS/ME, but really I have no idea whether I should just put this down to ''my body is all fucked up right now'' and wait to see the rheumatologist in October, or whether I should be down the GP going ''please check if my heart is fucked.''
Any ideas? And if so, any advice on how to get them to take me seriously rather than just going, ''low blood pressure is good, we like low blood pressure, drink more water,'' which is what happened last time.
Other maybe relevant details - I'm in my early 30s, female and skinny, and don't have any other ongoing health problems.

posted by BlueNorther to Health & Fitness (15 answers total)

I am not your Doctor, but based on your level of concern, and the symptoms, it sounds like it is definitely worth going back. You can also go to a different GP if you feel like it would help/get a different perspective.

Hope you feel better.
posted by troytroy at 1:23 AM on August 16, 2016

i had a recent heart "scare" and my doctor was a lot more concerned than yours seems to be. i would try seeing another doctor, as soon as possible.
posted by andrewcooke at 3:35 AM on August 16, 2016

I'm pretty much housebound at the moment due to pain, fatigue, muscle weakness and general unsteadiness. I'm also losing a lot of weight, very rapidly, despite being less physically active than I've ever been in my life until a month ago.

Yeah find a different doc, these severity of symptoms should at least merit concern from him/her.
posted by aetg at 4:25 AM on August 16, 2016 [2 favorites]

Push for earlier dates! Ask to see the rheumatologist faster and get a cardiologist referral if you can - women, especially younger women, often don't get listened to for heart related conditions. Halter tests for heart conditions are so much lighter and easier to do now than just a few years ago and are pretty standard for figuring out weird stuff that's not showing up during a quick office check-up. Rheumatologists turned out to be mostly the nicest doctors (they're used to chasing down mysteries because they deal with weird interactive systems all the time in the body) I've dealt with. A GP isn't going to have the equipment to figure out anything much beyond the most obvious conditions which would have already shown up with other noticeable symptoms.

Have you had iron and vitamin D/B deficiency and thyroid levels checked? Those sometimes get skipped in the regular blood tests and are relatively common issues to cause weakness etc. and a GP can order those tests and the treatment doses.
posted by dorothyisunderwood at 5:27 AM on August 16, 2016 [1 favorite]

It is hard to interpret you numbers, especially your heart rate, without knowing what you were doing at the time and how you measured them. Having said that, it sounds like an evaluation by a cardiologist is not unreasonable. That should probably take priority over the rheumatologist visit. There are a number of tests the cardiologist may want (including the above mentioned Holter monitor), but that will depend on his history and physical findings. Based on how that visit goes you may have something that needs treatment or you can concentrate on non-cardiac causes for your problems.
posted by TedW at 5:37 AM on August 16, 2016

Sorry you've been feeling this way. Low blood pressure in women is a legitimate issue that often gets brushed off by doctors as being Great! Perhaps look in the directions of POTS (postural orthostatic tachycardia syndrome). It's an pretty common condition usually characterized by a drop in blood pressure and increase in heart rate when standing (which is why seated blood pressure monitoring usually shows nothing). I was diagnosed with it a few years ago by a cardiologist who had me take a tilt table test.

However, this is not to say that it could not be something else entirely. Point being, breathlessness, dizziness, and a pounding heart are NOT okay. Please push for a referral to a specialist, or a second opinion.

Please memail me if you have any POTS questions.
posted by eggs at 5:37 AM on August 16, 2016

Response by poster: Thanks, guys, this is helpful. I guess I'll go back and ask some more questions. I've heard of POTS and it did cross my mind.
posted by BlueNorther at 5:46 AM on August 16, 2016

I came in here to state that it reads like you have a textbook case of POTS, but a few have already beat me to it. POTS is defined as a heart rate increasing by 30bpm (for an adult) while your blood pressure doesn't keep up.

I , too, have POTS. The most common demographic for POTS is 15yo girls who don't eat enough, and I am none of those things (male, 38, eat plenty), but the Mayo Clinic has recently determined that it affects all demographics equally, it's just that 15yo girls who don't eat enough are the most typical to complain and do something about it, so if you aren't that demographic, doctors usually overlook it. Plus, it requires very specialized tests (such as the Mayo Clinic) that very few places are equipped to perform.

Being tested for POTS is fun...not. But you can help it by drinking tons of very cold water and keeping your sodium intake up....waaaaay up (I am on an extra 10,000mg/day), and wearing a body brace to keep your blood from pooling in your abdomen.
posted by TinWhistle at 6:35 AM on August 16, 2016

In my experience, cardiac stuff is often about symptoms. If someone has a BP of 80/50, but they're talking and saying that they feel fine, that's a much different situation than a person who has a BP of 120/80 but says that it feels like an elephant is sitting on their chest. My point being, regardless of what your BP and HR are, you're having these concerning symptoms, so you should get them checked out. Note: this is a general rule of thumb, there are certainly serious cardiac conditions, like silent MI, that can have few or very subtle symptoms. I am an RN, but I am not your RN etc. etc. etc.
posted by brevator at 9:03 AM on August 16, 2016

Definitely ask them to check your thyroid levels if they haven't already. Fatigue, muscle weakness, unsteadiness, weight loss, and heart palpitations are all symptoms of thyroiditis. (Also hand tremor, difficulty swallowing, anxiety, and insomnia, if you've got any of those.) Early 30s female is the classic time for this, too. (In fact, so classic that I'd be surprised if they didn't check you for it already, but who knows.)

I've been there -- it's very scary while they try to nail down a diagnosis. But don't be afraid to push for yourself! You know something's wrong, you've just got to keep on them until they get it worked out. And here's hoping it's something not that serious that they can get fixed right up.

Good luck!
posted by pie ninja at 9:51 AM on August 16, 2016 [1 favorite]

Nthing thyroid. You might need to see a really good specialist, though, because in my experience, almost all GPs are terrible at diagnosing thyroid problems and taking them seriously. Actually, a lot of them fail to take women seriously, as you and I have both experienced.
posted by LoonyLovegood at 12:32 PM on August 16, 2016 [1 favorite]

Did you have a blood smear or a very thorough blood panel? It sounds a lot like a b12 deficiency I had, like exactly like it. But your b12 won't measure correctly low if you take any supplements at all including multivitamins, so they need to look at other stuff: in my case mma, homocystine and intrinsic factor antibodies. Also your folate levels need to be good to use the b12. I'm sure there are other similar conditions but that's one to ask about for sure. The symptoms are basically hematologial and/or neurological. Breathless, anemia, fatigue, weight loss, nerve pain, neuropathy and ataxia etc. I had a ton of muscle wasting, especially in my core and upper legs and arms. If your gp doesn't know all that, just go to another doc for a second opinion . It's easier than trying to educate this one.
posted by fshgrl at 2:44 PM on August 16, 2016

The weight loss and rapid heart rate also made me think of hyperthyroid. A couple years ago I was losing weight without really trying (but I just thought "cool" since I needed to lose weight) and one day noticed that my heart rate was around 120. Went to the doctor at that point, had abnormal thyroid blood work, and woke up the day after the appointment in atrial fibrillation. (Are you also feeling overheated all the time? That was my initial symptom.)

So definitely not something you want to let go too long, because atrial fibrillation increases your chance of stroke. I could tell immediately that my heart beat was irregular, but apparently many people don't know they have it until it shows up on the ECG.
posted by Bresciabouvier at 8:04 PM on August 16, 2016

If your heart rate is 140 at rest, you really ought to go in and be evaluated in the emergency department if you are taking that heart rate accurately. IANYD but there are very few circumstances under which that would be a normal heart rate.
posted by treehorn+bunny at 7:04 PM on August 17, 2016 [2 favorites]

Response by poster: I do wonder if that can possibly be accurate. It's really felt like it's racing, but that seems improbably high, right? If nothing else, I'd kind of like to have my numbers properly checked and looked at by someone who knows what they're doing, because as someone said upthread, it's pretty hard to interpret the numbers and I can't be sure how accurate my measurements are.
Anyway, thanks everyone, I've made an appointment and you've given me some good ideas for how to ask constructive questions.
posted by BlueNorther at 5:47 PM on August 18, 2016