Anyone, what sort of tests would show autonomic dysfunction? Can a regular general physician look for this, or is this something you go to a specialist for?


So far, I have had a brain ct, abdomen ct, 3 chest xrays, 3 ekgs, a echo, blood drawn 5 times, urine 3 times

Tests that they want to do, a exercise stress test, tilt table test, 24h ECG, sleep study, and neuro eval.

Thanks! No one had told me that!

The tests you said they want to do would be a good start. I'd suggest getting those first.

I have been noticing something that the doctors seemed to want to ignore. Most of my symptoms of syncope/near syncope are when I stand up (especially after sleeping), bend over, going up stairs, reaching up high to get something.
My heart will thump really hard, or beat really fast during the syncope episodes.

Today I decided to wear my exercise heart rate monitor to see my heart rate when I did these things. When laying I waited for my HR to dip to low 60s-mid 50s, then stood up, and my HR would spike to around 100-110 before dropping back down. A spike of 35bpm and I feel the symptoms, while a spike of 45 and I feel a near blackout.

I was told in the hospital that the HR spike was normal, nothing is wrong with that. The explanation was because my HR rises, that rising was normal, that HR dropping when standing would be a bad thing.
This seems to contradict what I read online, so I am wondering if a HR spike of 35-50 bpm really is normal range.

That is not a normal heart rate response to standing. It may be beating faster to accomadate for a drop in your blood pressure which is what you would ideally want to measure. Your PCP can do orthostatic vital signs at the office or you can buy an automatic BP sensor and do it yourself at home. You may be getting faint because your blood pressure is dropping when you stand up.

Treatment

Individuals with mitral valve prolapse, particularly those without symptoms, often require no treatment.[20] Treatment with magnesium supplements may help reduce symptoms of MVP.[21] Those with mitral valve prolapse and symptoms of dysautonomia (palpitations, chest pain) may benefit from beta-blockers (e.g., propranolol). Patients with prior stroke and/or atrial fibrillation may require blood thinners, such as aspirin or warfarin. In rare instances when mitral valve prolapse is associated with severe mitral regurgitation, mitral valve repair or surgical replacement may be necessary. Mitral valve repair is generally considered preferable to replacement. Current ACC/AHA guidelines promote repair of mitral valve in patients before symptoms of heart failure develop. Symptomatic patients, those with evidence of diminished left ventricular function, or left ventricular dilatation need urgent attention.

[edit] Prevention of infective endocarditis

Individuals with MVP are at higher risk of bacterial infection of the heart, called infective endocarditis. This risk is approximately three- to eightfold the risk of infective endocarditis in the general population.[1] Until 2007, the American Heart Association recommended prescribing antibiotics before invasive procedures, including those in dental surgery. Thereafter, they concluded that "prophylaxis for dental procedures should be recommended only for patients with underlying cardiac conditions associated with the highest risk of adverse outcome from infective endocarditis." [22]

I had an aortic valve repair in 2007. It took care of a lot of issues (before new ones arose)

I was at the cardiologist the other day, he said the same thing about the heart rate. He didnt do the standing up blood pressure test, and ruled out the need for a tilt table test. He gave me the idea that because I know I have problems blacking out when standing up, that there really is no need to waist time and money to confirm it.
So, the plan is to figure out what is causing the issue, by wearing a heart monitor for two weeks to record the events, then figure out treatment