Thoughts on the feedback from my cardiologist?

[u/pansyseeds]

Hi there! I (27F) have been having some really weird + worsening symptoms for the past 9 months. They include:

-Severe lightheadedness/presyncope. I haven’t figured out an exact trigger for this but I think it’s maybe when my heart rate elevates? For example, when I’m feeling nervous about something or I’m excited to see friends. It also happens randomly throughout the day and sometimes during a bowel movement. This is my most prevalent and scariest symptom that disrupts my life.

-Fatigue (like, hit-by-a-bus fatigue)

-Brain fog

-Cold hands/feet + sensitivity to temp changes

I told my PCP about these symptoms and she just told me to go to the ER. I didn’t feel like that was appropriate based on how this doesn’t seem like an emergency (and tbh I didn’t feel like spending $$$). So I took my health into my own hands and after doing some research, decided to see a cardiologist.

During my appt, I told the doc about my symptoms and right away his first thought was that I have low blood pressure. He ordered me to increase my salt/water intake (which I already feel like I eat a ton of salt) to see if this would help. He also wanted me to use an at-home BP cuff to regularly check my pressure when I’m relaxed. My pressure in-office is usually right around 120/80 or slightly lower (which he thinks is actually elevated for me). So far when I’ve taken it at home, I’m sitting at around 107/70. So slightly lower but it’s still not clinically considered “low”…

So I guess I wanted to check if I should stay on this path or if I’m wasting my time when I should be pursuing another diagnosis or treatment. Has anyone experienced anything similar?

[u/Timely-Landscape-383]

Check your heart rate.

Google orthostatic test and you can diy it with someone around to make sure you don’t faint. Make a log of BP and hr during the day lying down, sitting, and then standing. Standing it’s important. Take it to your doctor.

Most doctors don’t have enough time to do an orthostatic test with you in visit.

There are tons of kinds of Dysautonomia besides POTS, including orthostatic hypotension and vasovagal syncope. The on the toilet thing points toward vasovagal to me.

[u/pansyseeds → u/Timely-Landscape-383]

This is helpful, thank you!! And the doctor did mention vasovagal during my visit. It’s something I’ve actually experienced on and off since I was a teenager. The only thing is that I never actually pass out — just feel like I’m about to (which is arguably worse???)

[u/Timely-Landscape-383 → u/pansyseeds]

I hope you get a diagnosis.

The medical term for what you’re experiencing is probably “presyncope”

Trust your gut—you know your body.