Up Date

Well, I have been posting a couple of time regaring low blood pressure while NOT pacing. When I do pace, I feel fine. My docotor is very frustrated and not sure what to do next...she says that I am one of the hardest cases that she has seen in years.

Well last night I fainted again, hit my heard on the bathtub, and found my way to the hospital wiht my husbands strict orders. Some of the EKG's were abnormal, and the low blood pressure while NOT pacing was confirmed after several hours on the monitors. Blood pressure what completely normal while the pacemaker was doing all the work.

I don't know what's gping on, my doctor is frustrated, and I just don't know what to do. :(

Amanda

8 Comments

Thanks!

by scadnama - 2008-07-03 01:07:20

Thank you Smitty! I have had such a hard time convincing people that I am not a nut case! While in the ER last night my suspicions were confirmed, but of coarse my doctor wasn't there, so I just don't know where to turn at this piont. Something must be done...I cannot live my life this way forever. I was fortunate enough to only get a good knock on the heaf this time, but what's gonna happen next time?

Low Blood Pressure

by Pookie - 2008-07-03 08:07:26

Hi Amanda!

Have you ever asked the doctor about Hypotension Intolerance or Neurocardiogenic Syncope? Have you ever had a Blood Pressure Monitor? A Tilt Table Test? Do you drink a lot of water? How is your salt intake? Compression stalkings might raise your blood pressure. What is your Ejection Fraction? Just a few ideas if they can help.

All I can say is I wish you the best of luck and push those doctors until you get an answer!!

Pookie

Low BP

by SMITTY - 2008-07-03 11:07:07

Hi Amanda,

Let me start this by saying that the entire world knows I'm anything but an expert on heart and pacemaker problems. But your problem is like others I have read about recently and I have, in all my great wisdom, formed an opinion about these.

My logic tell me that your heart's natural pacemaker is sending out electrical impulses that are sufficiently strong to make your heart go through enough of the motions of beating that it keeps you going and it may even fool the EKG machines. However, the heart chamber contractions caused by the heat's natural pacemaker are not strong enough to cause a strong enough contraction by the ventricle to give a forcible push to the blood leaving it for distribution throughout your body, therefore your blood pressure is low. But, when the pacemaker comes on line and provides the electrical impulse (which is much stronger than the one supplied by your heart) to make the heart chambers contract, you get a faster and stronger chamber contraction which results in a higher blood pressure.

Now I'll go back to my little cubby hole, pull the curtains, light the candles and see what other brilliant ideas I can come up with.

I wish you the best,

Smitty

Rate Response

by scadnama - 2008-07-04 01:07:59

My rate response is turned on. Everytime I get my pacer checked whether it has been 24 hours, or 3 months, I have always used the max amount of recordable space on my pacemaker which is 254 rate drop responses.
I currently pace at about 70%.

Low BP

by ElectricFrank - 2008-07-04 02:07:58

This would seem to be a situation where turning rate response ON would be helpful. I tend to agree with Smitty that your heart beats more efficiently when it is receiving pacing pulses. So turning on rate response would assure that you are pacing 100% of the time and your BP would stay up.
Can you arrange to see the pacemaker rep for a programming session. I question the docs knowledge if he is frustrated by the situation. This isn't surprising and isn't a criticism of the doc. He is just outside his expertise.

frank

Low BP

by maryanne - 2008-07-04 04:07:01

Hello Amanda....

As Smitty, Frank and Pookie have eluded there are many reasons for a low BP.

Dehydration and volume depletion
Medications - Calcium channel blockers, Beta blockers, ACE inhibitors, Diuretics,and meds for Parkinson's or Depression can all have an effect on BP
The Heart as an ineffective muscle caused by an MI(Heart Attack) or Aortic stenosis, or a Pulmonary emboli or pericarditis can all have effects on your BP.

So if all of the above have been ruled out, it would lead one to believe that your hearts intrinsic beat is not effective enough to pump effectively which leaves you with a low BP. I tend to agree with Frank and maybe you should ask about the Rate Response and you just might require being 100% paced.

Please keep us posted.....all the best

Mary Anne

Another opinion

by auntiesamm - 2008-07-04 08:07:55


I haven't been on in quite a while so I am trying to catch up. I'm thinking you need to get another opinion in your case. There are many cardiac "Centers of Excellence" around the country where the best of the best are seeing patients and constantly researching and developing new treatments. One that comes to mind is Cleveland Clinic and I know there are many others. Why not ask your cardiologist? He may be relieved for you to broach the subject of a second opinion since he is himself frustrated. Definitely you have some problems that need to be taken care of! Print off Smitty's response and take it with you to your next appointment! I think most of us have found his research and reports back to us have been sterling! Please be careful so you don't faint and hurt yourself. Maybe we could surround you with bubble wrap and a helmet. LOL Please consider everything that has been posted here and let us know how you are doing. I ask the good Lord to hold you close in the palm of His hand and keep you safe. Blessings....

Sharon

Pookie

by scadnama - 2008-07-04 12:07:56

I have been diagnosed with Autonomic Dysfunction, Neurocardiogenic Syncope, SSS, IST. I do have a bp monitor at home and check my pressures often. I have had 3 tilt tests. I drink at least 8 - 8 oz. glasses of water, lots of gatorade, and no caffeine.
I spent the night in the ER last night, and the monitor would show big drops in my blood pressure while not pacing. When I pace, I feel great. It is so confusing, and my doc is not sure what to do.
Thanks for you advice,
Amanda

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