[Interested]

Wrote the other day that Son had experienced high blood pressure which he never had before. Strange things have happened. For a couple of days bp was higher, but then it went back to normal. However, his heart rate jumped to 136, and stayed between 132-136. He also was having gastric disturbances and felt weak. After ending up in the ER and getting IVs. They got the heart rate down to 90 (really wanted to get it down in the 80s), and he was released after approximately six hours. His heart markers came back normal as well as other tests, but his white cell count was elevated at 1800 and temperature was 100.6 degrees.

The following day his blood pressure took a dive and his diastolic pressure was only 43-45 while his heart rate was 100. After resting the entire day, that night both rate and pressure were normal and temp was 100.1 degrees.

Perhaps he had an infection along with problems getting medication regulated. I don't know. I've read that prednisone can raise the heart rate plus raise the white cell count, and mestinon can lower the rate and blood pressure. Of course, an infection can raise the white cell count and cause a temp. This just raises more ???? He has an appointment with his family doc on Monday to check further.

Have any of you experienced fluctuating blood pressure and an increased heart rate??? Maybe I should be more specific and ask whether you have experienced low blood pressure while your heart rate was raised. If so what was the determined cause?

Thanks in advance for any input.

Interested

[AnnieB3]

Your son's primary doctor could run a few basic tests like erythrocyte sedimentation rate (though it's a nonspecific test) to see if there is an infection. Pred can mask the signs of infection.

How long has he been on the Pred? What else is he on? Did he recently have anything like IVIG or plasmapheresis? Have they checked his D-Dimer (to look for signs of a clot)? Does he stay well-hydrated?

I don't think we can really help. He needs to see a doctor to figure this out. Whatever is causing these symptoms, they aren't normal and he needs an answer as to why they are happening. I hope you can figure that out with his doctors.

Annie

[southblues]

The only way that the body can keep cardiac output constant in the face of dropping blood pressure is to raise the pulse rate. And conversely, the only way that cardiac output can be stable with high blood pressure is if the pulse rate drops.

In spite of all this, he needs a good diagnostic workup. I hope he is ok.

[Interested]

He has only been on prednisone for about 4 weeks. He takes 40mg daily and also takes 180mg slow release mestinon. He has not had an IVIG or plasmapheresis. I will tell him that he might want to ask his doctor about getting an erythrocyte sed rate and checking his D-Dimer. Son appears to drink plenty water, but I will remind him of its importance.

You are correct. His doctor will probably be the only one who can figure this out. Sometimes it is a little frustrating because the ER felt like his neuro should take a look at his meds, but the neuro didn't want to change anything at this time and thought Son needed to see his family doc and get bp medicine to lower his bp. It had been elevated during his neuro appointment. We don't feel like that is a good idea because of the bp fluctuation and wouldn't want him to bottom out.

Thanks for the advice and certainly hope you are feeling better, Annie. I will continue praying for your health.

Interested

[bny806]

I don't have a concrete diagnosis.. but whatever I have has affected my heart rate and BP since day one.. They question that I have dysautonomia/autonomic dysfunction. They tested me for POTS on the tilt table.. from what I know when you have anything neuromuscular going on it's not that uncommon to have POTS/dysautonomia or something like that to go along with it.


Maybe he should looked into getting tested for that ?? I wore a holter monitor and it showed my heart rate going into the high 130's it seems random when it does this.. but many times it's after eating.. .. Prednisone made my heart rate go into the 150's.. then again I have so many issues going on, who knows!

Good luck!

[rach73]

Bny806,

You are so right - dysautonomia / autonomic nervous system rears its ugly head with so many people that have autoimmune diseases yet everytime it is raised on this forum its seems to be brushed over.

Mestinon raises blood pressure (standing bp) and is given to people with orthostatic intolerance and postural orthostatic tachycardia syndrome to name just two of the many different forms of autonomic nervous system problems. (see the links I provided on another thread last week).

My heart goes like the clappers on occasion when my blood pressure is low 72/40 is enough to get it to 160 beats per minute as it works furiously hard to increase my blood pressure. However on occasion my heart rate can be normal when I have a low bp thats the nature of the beast.

If any of this is happening to you see a Dr who knows about ANS dysfunction and get fully checked out rather than assuming its a medication issue and ignoring it. There are diseases of the Autonomic Nervous system that are fatal (I dont wish to scare anyone) so ruling them out is always a good idea and very reassuring. Many ANS dysfunction symptoms can be treated and / or alleviate the very debilitating symptoms.

ANS dysfunction is closely linked to autoimmune disease, it may interest you to know many people who have it also have positive ACHR tests and arent diagnosed with MG.

Rach

[art chick]

I have experienced an array of fluctuating blood pressure and heart rate issues and have been fully evaluated by a cardiologist and had a 30 day monitor and an echo, etc.

My tilt test was positive and I was diagnosed with POTS. I have BP spikes that would only last for a few minutes, sometimes I would also have low BP that would last for longer. When I had major fluctuations with high BP, I got very weak and would have trouble walking without a walker (even when I had been strong earlier that same day). Then, I would wake up the next morning and strength would be restored again.

The most concerning symptom was my random tachycardia, the doc said. It would go up within seconds to 160 for any little thing, such as lifting my arms, leaning over and standing back up, climbing one flight of stairs or styling my hair (if I kept my arms up, it would stay up the WHOLE time!).

The doc put me on the lowest dose of atenolol (12.5mg). The tabs are 25mg and are not even scored for cutting (my dose is so low) but it is working perfectly for the tachycardia. I have not had any in the last 3 mo. Beta blockers are relatively contraindicated in MG, so you have to be very careful on that note.

I hope you find answers soon!

[Quandry]

My blood pressure is high when I have inflammation and my c-reacitve protein is high. Is your son swollen?

[Interested]

Face seems to have some swelling and so does upper abdomen which could be related to the gastric disturbances.

[4-eyes]

Those swellings are normal when on pred, Interested. It is called being "Cushingoid." Gastric disturbances also happen with pred, which is why it needs to be taken with food.

Pred is such a love/hate drug. Hope Son gets answers soon.