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Lessons from ME/CFS: Finding Meaning in the Suffering
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Scary Low Pulse Pressure

Discussion in 'Autonomic, Cardiovascular, and Respiratory' started by Sparrowhawk, Oct 2, 2013.

  1. Sparrowhawk

    Sparrowhawk Senior Member

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    I learned here from various folks including SOC what a pulse pressure is and how to calculate it. Which is a good thing because I was feeling kind of terrible all of a sudden today, just sitting at a desk, and took my BP. In series here is what I saw this afternoon:

    Time / BP/ PP

    1:59 106/85 @ 95BPM, seated, Right arm, Pulse pressure 21
    2pm 116/86 @ 92 PP 31
    2:01 107/85 @88 PP 22
    2:02 113/82 @91 PP 31
    2:03 104/81 @ 89 PP 23 <-- This was the first time I've ever seen my BP monitor display the little shaky heart symbol, showing an unstable beat/contact your doctor message (whom I will be seeing tomorrow).

    by 3:30 I was consistently back up at like 122/86 @ 84 BPM, PP 36

    I read in wikipedia that anything under 25 is, well, bad.

    I've seen PP as low as 27 or even 25 but never 21.

    For POTS/OI I've been dosing salt and occasionally using the electrolyte drink SOC had recommended, but I didn't use it today. This actually started out as good heart rate day (didn't see any early morning tachycardia like I usually get).

    My cholesterol is crazy high but I don't think that should affect pulse pressure. I have had a history of occasional atrial fib, and think I had a brief episode of that as recently as last Sat night. But this didn't feel like that, e.g I didn't feel the usual "limbs going to sleep" feeling of the afib.

    Anyone else deal with periodic pulse pressures this low? Any ideas? Things I should ask the doc tomorrow?
  2. SickOfSickness

    SickOfSickness Senior Member

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    I read about low PP being bad too. I had PP from 15 to 20 often, and sometimes below 15. I have OI.

    My doc said don't worry about mine because I wasn't having worrying symptoms. (This was not a sympathetic ME doc, just a regular one.) But I didn't worry about it. I gather that people might have bad symptoms at 20-25, or no symptoms at 10-15 or less.

    My PP goes lower depending on positioning when BP is taken.
  3. Sparrowhawk

    Sparrowhawk Senior Member

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    SickOfSickness thanks that's actually comforting to hear. I wouldn't be worried except that when it was happening I felt alternately crap, or "pretty ok" and as you can see the pulse pressure was going back and forth from pretty normal to pretty low.

    So when you had PP 15-20, was that sitting or lying down?

    Thanks again for the response.
  4. Valentijn

    Valentijn Activity Level: 3

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    The unstable heart beat message probably doesn't apply. Basically when your pulse pressure gets low enough, your pulse is just too weak for the BP monitor to detect it consistently. So while this is a problem, it's probably not an irregular heart beat problem :p

    I think my lowest reading was 16. It probably gets lower at times (at least, when I'm off Strattera), but then the BP monitor won't pick up enough heart beats to give any reading at all, and will just give a nice ERROR message.

    Although 25 is considered very bad, it's been my experience that anything under 35 feels icky. 40-50 feels pretty good.
  5. Sparrowhawk

    Sparrowhawk Senior Member

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    Valentijn, thanks, boy I would really welcome a pulse pressure of 40-50. I don't think I've been over about 35 since I've been measuring it.

    Again it's really comforting to hear y'all have had comparably low, or lower Pulse Pressures than what I had today. I will definitely sleep better tonight knowing that. Thanks again.
  6. SOC

    SOC Moderator and Senior Member

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    Daughter and I will occasionally get PP in the low 20's, but not for an extended period of time. I don't think it's a big problem under those circumstances.

    I have a hard time getting my resting PP in the high 30's, too, although I feel best when it is.
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  7. SickOfSickness

    SickOfSickness Senior Member

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    Yeah, error message when the bottom number is too low.

    Well, I don't think I have POTS, but any position where gravity could get blood down to my feet more?

    More than position, it was about whether I was tense or relaxed. Relaxed meant lower PP.
    Valentijn likes this.
  8. SickOfSickness

    SickOfSickness Senior Member

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    Dehydration may be a part too. For me I think it was.

    And of course depending on meds/supplements that I took or missed.
  9. Sushi

    Sushi Moderator and Senior Member Albuquerque

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    Do you have a cardiologist to check with? Preferably one who is familiar with autonomic dysfunction?

    I had a PP of 8 on a TTT--really, but really felt like crap then!But normally, for me it is about 45. My PP is less when I am extra tired or under physical stress like a TTT (which is of course extreme physical stress).

    Sushi
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  10. Sparrowhawk

    Sparrowhawk Senior Member

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    I'm meeting with my primary care guy tomorrow. We will see if he thinks it worth referral to cardiology. Kaiser in the past did the whole holster monitor for me and didn't find anything. But it's like taking the car to the mechanic and suddenly it stops making the noise you brought it in to get fixed. ;-)

    Super normalizing to hear from everyone on this, thanks for the support.
  11. Sushi

    Sushi Moderator and Senior Member Albuquerque

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    We don't seem to die from low pulse pressure and seems like a bunch of us have tested that out! :cool:

    But it isn't great in that it makes us feel like hell. My autonomic specialist seemed more interested than alarmed when mine went to 8. Said he had seen worse! Hope your PCP has some helpful thoughts on this.

    Sushi
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  12. Ruthie24

    Ruthie24 Senior Member

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    Like Sushi, my worst PP has been as low as 8, but not uncommon to get 10-12 for me. The problem is when your PP is that low, you just aren't moving blood very efficiently so you feel really lousy. According to my POTS neuro this is a common problem with us so he too doesn't seem to get very excited about it.
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  13. Sparrowhawk

    Sparrowhawk Senior Member

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    I'll take all this info in to my Doc this morning, folks. Will see if I can get a referral to a knowledgeable cardio person, but it is sound like this is just another wonderful thing to be expected with this condition. Thanks again, all...:hug:
  14. Valentijn

    Valentijn Activity Level: 3

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    Yeah, tensing muscles is a really good way to raise pulse pressure. I think it's the primary recommendation for people who just have OI (without ME/CFS). I feel way better when I do it, but I can't do it for long and then I crash from the exertion :D
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  15. SickOfSickness

    SickOfSickness Senior Member

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    Yeah, I tense them automatically, and sometimes don't realize. I know it's using energy up :(
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  16. Sushi

    Sushi Moderator and Senior Member Albuquerque

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    We had a navy pilot come into our support group to teach us the "tensing exercises" that pilots do to offset the tendency to pass out when under G-strain (plus they us G-suits which are like really high-tech, ugly, compression garments.)

    Passing out for them has more consequences than for us! :D

    Sushi
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  17. Sparrowhawk

    Sparrowhawk Senior Member

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    Update on this, I did get a referral to a cardio specialist, but that will be some weeks (you know how it goes with scheduling). My Dr. this morning said basically what you all did, which is it is not a clear near term threat, but worth getting checked out. Thanks again for holding my (virtual) hand through this!
  18. Ruthie24

    Ruthie24 Senior Member

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    My husband had been suggesting a G-suit for me ever since my POTS diagnosis was made.;)
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  19. Sushi

    Sushi Moderator and Senior Member Albuquerque

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    Just watch out for the ones for sale on Ebay as many of them leak! Anyone buying one there, get it in writing that you can return it if necessary.

    Sushi

    Look below, cute, hey! ;)

    [​IMG]
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  20. Valentijn

    Valentijn Activity Level: 3

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    I'll look awesome riding around in that when I get a Tron-style mobility scooter :lol:

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