Autonomic neuropathy?
 

I was diagnosed with idiopathic PN almost a year ago after a nerve conduction study. I mostly have had parastesia in hands, feet and face, but my symptoms can vary. The PN seems to focus on my left side. I have pain on the left side of my neck and shoulder and severe sciatica in my left leg sometimes. I have had a lot of tests done but I am still searching for what is causing this.

Anyway, I had been having left sided chest and shoulder pain for awhile sometimes with shortness of breath. About 2 weeks ago I experienced heart palpitations that were very alarming to me, so I went to see my PCP who then referred me to a cardiologist. I have seen the cardiologist and he has ordered a stress test and eco cardiogram? or something like that. I had the stress test done the other day and it showed palpations when standing from a seated position and when walking on the treadmill. I am still waiting for the eco test. I mentioned my PN to the cardiologist and he said they are unrelated. However, I keep thinking that maybe I am in the early stages of autonomic neuropathy.

What did the doctor say about the stress test? There is usually a doctor present during the test, so he should have given you his assessment/diagnosis. Did he say it might be postural orthostatic tachycardia syndrome (POTS)? If so, this is an autonomic dysfunction.

en bloc
 

The doctor wasn't present during the stress test. There was a technician there that would tell me when the monitor would register the palipatations. They didn't feel like much during the test compared to the alarming one I felt that prompted me to go to my Pcp. Its possible that i have been having them awhile and just didn't realize it. I often get dizzy when I stand but don't necessarily feel a heart palipatation. The technician said they were checking for heart murmer or mitro valve prolaps. He said the echo test will determine a abnormality in the heart valves or if the heart is enlarged. That's all I know for now until my echo test next week. Then the doctor will call to discuss the results. He did mention the possibility of putting me on a beta blocker.

I was on a beta blocker for several years for migraine prophylaxis; later I found that some can cause PN, so it's a possible suspect in my own idiopathic PN. There may not be anything to do about it -- heart outweighs PN -- but it might be something to be aware of.

Doc

neuropathic POTS and hyperadrenergic POTS
 

I have been researching POTS and came across some information. Apparently, some POTS is neuropathic - caused by peripheral denervation and others are hyperodrenergic POTS - caused by overactivity of the sympathetic nervous system. I think my cardiologist was thinking mine is the hyperodrenergic one. However, I'm wondering if it could be the neuropathic one since I do have peripheral neuropathy.

POTS is caused by so many illnesses. Mine is Autonomic Neuropathy. I was so happy to find out so my doctor and I could work to help me heal the nerves. Supplements, nutrient dense foods, no sugar or bad carbs have been wonderful.

lindsayjane, do you have POTS? It is terrible.

Sallysblooms
 

I don't know if I have it. I am having tests done by a cardiologist because I began having severe heart palipatations. I checked the symptoms of POTS and I have many of them. I have done a stress test and have a echo cardiogram scheduled later this week. How was your POTS diagnosed? What kind of tests did your doctor do?
Thank you,
Lindsay

The test that most people get is the Tilt Table test. A neurologist will do that. I was MUCH too ill for that. They put you on a table and tilt it so you are up and I was mostly bedridden and in my w.chair. No possiblity of that test. My doctor gave me other tests, but I can't remember the names. I was so ill.

One of my tests was like the tilt. Lying down, sitting and standing. BP was taken at each one and my heart was tested also. Several times. I can't remember the other test. I had already been to the cardio doc. They knew nothing about Dysautonomia. I saw two different cardiologists.

The diagnosis for POTS is when the heart rate is more than 30 beats per minute when standing.

Like Sally said, the tilt table is the most common test. Don't worry about falling off or problems with the test...you are strapped to the table and the tilting is not fast. It's similar to just checking BP & heart rate while laying down, sitting, then standing...just in a more controlled way since you are strapped to the table and have monitors, etc. Pretty easy test.

In some (but NOT all) patients they give a medicine to try to induce the symtpoms. I never needed that because my dysautonomia was so profound and always detected immediately.

Last Christmas, I suddenly noticed that I was having heart palpitations, frequently in the evening, but other times too. Went to PCP who referred me to the cardiologist. I took a stress test which seemed to go ok, but that is only 6 minutes or so. So they put a traveling EKG machine on me to monitor my heart for 24 hours. The end result is that I was having a mild form of heart palpitations. We adjusted my blood pressure meds (Accupril) and lowered my gabapentin and had me eat a banana a day. Seemed my potassium levels were low, caused by taking too much accupril. I'm much better heart wise now, but I'm still suffering some incon issues that is AN or PN or diabetes related. Drs. don't seem to want to look further if it isn't a major problem. I guess they think wetting your pants is not life threatening, which it isn't, but my heart goes nuts every time it happens. I hope you get some resolution to your problems. I think Drs. sometimes pigeon hole patients and don't listen to what we want.