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Old 04-17-2003, 06:29 PM   #1
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Question sudden spikes in blood pressure

My husband has been experiencing episodes in which his pulse rate drops rapidly accompanied by a spike in blood pressure from normal readings to as high as 198/129. He also feels a feeling of pressure behind his left eye with tingling in his lips, has difficulty speaking, and becomes pale/sweaty. Within a few minutes his BP returns to normal and the symptoms subside; sometimes he has what feels like a hangover for several hours after the episode. Due to a very low pulse (30), a pacemaker was implanted which keeps his pulse from dropping dangerously low, but the episodes continue. They are not predictable and have occurred while just sitting, talking on the phone, exercising, shaving, etc. Many seem to have been associated with some increased tension, although he is a very laid back person and does not think he feels stressed. Just talking about the experience can bring one on and he has had episodes in the presence of doctors numerous times. The doctors are perplexed as BP usually drops when pulse drops. Any one have any ideas?--all scans, blood work, heart tests, etc. have not explained these symptoms. Thanks

 
Old 04-17-2003, 11:11 PM   #2
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could it possibly be a panic attach your husband is experiencing?..you can feel totally relaxed and have a panic attack..bp will spike, dizziness, weakness, pins and needles/tingling feeling, headache, and general sense of something bad is going to happen...you might want to discuss this with his dr and see what the dr thinks...alot of dr's blow off panic but believe you me, its a real issue and should be taken seriously, for it can really mess with the patients head...good luck.

 
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Old 04-17-2003, 11:58 PM   #3
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Thanks for taking the time to brainstorm with us--yes, we have considered that a panic type reaction may be part of what's happening; my husband actually tried a Xanax last night after experiencing an attack to see what, if any, effect it might have. I also experienced a difficult period of panic disorder in the mid-eighties. We are a Navy family and the stress of moving and sea duty can take it out of you. The intensity and the unpredictable and transient nature of my husband's episodes makes connecting a trigger with the events so elusive, but a surge in adrenaline is the most common tread. My husband, as a Navy Captain who has endure extreme stress under many circumstances, has nerves of steel. He has no feelings of dread or anxiety that is generally associated with panic--he has no difficulty breathing as I used to and no chest pain, etc. His bradycardia, low pulse rate, is real--usually, a panic attack would lead to a racing pulse, but I wonder if the drop in pulse rate related to a physiological break down of the heart's natural pacemaker has set up a conditioned autonomic response with release of adrenaline that causes somewhat of a panic attack and the subsequent spike in BP. Anyway, we have an appointment next Wednesday and will soon meet with a cardioelectrophysiologist who specializes in these types of problems. We will certainly explore the panic link. Thanks for the feedback--I continue to read and research and if next week's appointment produces no new ideas, I intend to plant myself in the nearest medical library and read more and more. Thanks for your support

 
Old 04-19-2003, 03:44 AM   #4
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Fattest dog,

I recommend that the doctor check out for 2 types of adrenal tumor (which can pump out adrenaline and noradrenaline which can give a HUGE and sudden BP jump. One is called a pheochromocytoma.

These adrenal hormones are the heart of the "fight or flight" response- like the feeling you get when a car screeches to a stop just inches from your child.


The tests involve urine gathering in a big jug for a day.
They are measuring something called vanillamandelic acid and another chemical (something like HIAA?)

 
Old 04-21-2003, 12:30 AM   #5
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Thanks for the advise Zip2play, which makes me believe we are on the right track. On Wednesday, we will get the results of a 24 hour urine sample in an effort to hopefully rule out adrenal gland problems. The doctor is also testing for less common illnesses, such as Lymes disease. Our reading in regard to adrenal problems does not seem to match what is happening, but a malfunction of adrenaline release would certainly help clear up the mystery. We appreciate your feedback and will let you know what happens.

 
Old 05-04-2003, 08:27 PM   #6
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I wanted to follow up on this thread. I have a relative who was experiencing the 'EXACT' same symptoms. I was wondering if you had any additional information regarding what the problem ended up being. Any additional information you could provide would be greatly appreciated. Thanks in advance.

 
Old 05-04-2003, 10:20 PM   #7
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Dear Concerned Relative, We also continued to be concerned as little has changed in our quest to understand why my husband is experiencing continued spikes in blood pressure that last only about 3 to 5 minutes. They are happening almost every day now, but the diastolic pressure is not getting as high with reading ranging around 150-160/85-95. The most notable symptoms continue to be difficulty swallowing and speaking and very pale and sweaty. None of the lab tests taken turned up anything wrong, although he will be getting a scan of his abdomen to further rule out any kind of tumor of the adrenal gland for example. Tomorrow we start a new round of appointments with new doctors including a new neurologist, cardiologist, and a specialist in the electrical system of the heart. We will also probably see an endocrinologist soon. Will keep you posted and am very interested in what is happening with your relative. There is definitely an emotional/adrenaline component to what's happening as being upset or thinking about the problem can bring an episode on. Regardless of the cause, we are now ready to try some medications to lessen the symptoms. Good luck--keep in touch

 
Old 05-05-2003, 04:39 AM   #8
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Thanks for responding with an update, I really appreciate it. The symptoms that my relative is experiencing include a sudden onset of high blood pressure combined with an extremely low pulse. The doctor had also mentioned the possibility of getting a pace maker although everyone is hesitant, since the doctor seems to be unable to provide an explanation for why the problem is occurring. Additional symptoms include light headedness, dizziness, and the inability to stand up. So far this has occurred twice (the first time worse then the second) and basically the episodes were once every 6 months. So it appears that they are infrequent and not necessarily stress related although I'm not positive about that. The symptoms lasted for a short period of time and then disappeared completely. All standard blood work comes back negative for what ever they test for. A stress test was conducted and showed that the heart was functioning perfectly and is in excellent physical condition. My intuition would be that it is related to a chemical imbalance, such as a thyroid problem, or something with the endocrine system, but I am not a doctor and have no basis for making these judgments. I'm attempting to organize an appointment with a better doctor at a better hospital in an effort to seek answers. I'll provide any additional information to this list as it becomes available.


 
Old 05-07-2003, 07:18 AM   #9
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concerned,

I'm not a doctor, but her's my first thought.
The lightheadedness and dizziness on attempting to stand is caused by low BP IN THE BRAIN! Hence probably low in the carotid artery (I don't know if they can measure that.)
I IMAGINE that soem sort of blockage or spasm might restict blood to the brain and cause the heart to try to pump harder (thus showing high BP in the arm.)

On the extremely slow pulse: is he on any meds that could cause this- especially beta blockers perhaps for angina? Any other drugs?

Another mechanism could be that the very slow pulse is the cause of the problema and that even with a higher pressure, the brain is momentarily starved because of the very low pulse rate. How low is it?

Any problem that recurs only twice a year is going to be REALLY hard to diagnose, and a pacemaker would seem to be overkill for something so non-debilitating.

Again, I'm just thinking off the top of my head!

 
Old 05-08-2003, 02:29 AM   #10
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Dear concerned relative, I responded to your last message two nights ago, but it didn't get posted; I'm not sure why. Anyway, we finally seem to have found a doctor who is willing to take some time with my husband to try and figure out what is happening. He had a very intense attack while waiting to see the new cardiologist on Monday with a blood pressure spike measured at 165/108. After taking almost an hour talking with us and reading in one of his reference books, he believes that my husband is having vascular migraines which can sometimes be very atypical when they first emerge at my husband's age. As the last message to you said, what might be happening is a temporary arterial spasm which restricts blood to the brain. The brain stem is the area that controls all my husband's symptoms including the pulse and blood pressure. A temporary dysfunction of the brain stem caused by a spasm may make my husbands pulse drop and blood pressure spike in an effort to get more blood to the brain. The doctor has given my husband a beta blocker to treat the vascular event. So far (only two days) he still has had a minor spell each day, but much less intense. Beta blockers can lower the pulse as well, but with his pacemaker, it can't go lower than 50. Do not allow anyone to put in a pacemaker unless his pulse is frequently very low. As it turns out having an occasional low pulse that rebounds quickly is not that uncommon and not generally life threatening. Our new doctor told us that the pacemaker was most likely not needed and that once inserted is very difficult to remove. We're just devastated that he may now have a pacemaker and all the problems that accompany it for the rest of his life. His dad is 85 and at 55, this means that my husband could put up with this for another 30 years. Reading on-line about pacemaker removal sounds like a nightmare with a high risk of infection. If this turns out to be migraines and we're praying it is, we feel so stupid that we were rushed into a hasty pacemaker without a second opinion and without doing our homework. Thrown into the emergency room and then ICU, we truly believed that a pulse of 30 was life threatening, but now know that lots of athlete's pulses go that low, even President Bush has a very low pulse rate. One doctor we saw Monday, said that my husband's BP had to be dropping before going up, but he is wrong, because even in the ER when being monitored, his BP never went down, only spiked. The earlier doctors just wanted to put my husband in one of their neat little boxes: low pulse must mean low BP which means syncope (fainting) and the need for a pacemaker. Well, my husband has never even come close to fainting and is totally cognitively alert during these attack, but earlier doctors ignored these facts. We had to pay $33.00 to get copies of the hospital records (as if the $36,000 hospital bill wasn't enough). Some of the information in these records sounded like another person with all kinds of elaborate information that has never happened including a description of passing out. It's all very scary how one can become a victim of the system and we are very well educated and good advocates for ourselves and we feel like we've been through a nightmare that's justs beginning. We can only imagine how difficult this process can be for individuals who are so much more vunerable. Your relative's symptom of not being able to stand up may well be some sort of syncope (fainting) related to a change in posture. There is a test called the tilt table that may be helpful in diagnosing this condition, but if the BP is going up rather than down, in my mind, it is most likely a neurological, vascular event, rather than a heart electrical system problem. Hang in there and make sure you have second opinions and do your homework before taking any dramatic steps.

 
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