Brief Answer:
even I disagree with sleep apnea too..

Detailed Answer:
Hello XXXX, welcome to HCM,
I've gone through your query and understand your concern,

I do appreciate your sharp observation and the precise details in this regards..

Your symptoms are typically indicating towards orthostatic/postural hypotension, a condition where there's a decrease in systolic or diastolic blood pressure within minutes of standing when compared with blood pressure from the sitting or supine position..

To establish this, you need to be undergone serial blood pressure recording and monitoring at different postures (lying down, sitting, standing) in different time intervals 3, 5, 10, 20 minutes, followed by a Tilt table test and a few more investigations depending on the findings..

"Moving helps the symptoms to decrease, but not entirely go away, keeping the feet elevated while sitting to help with circulation"- is another reason which supports this..

Even though your blood pressure is within normal range and Echocardiogram and labs are normal as per your description, still there can be swelling of the feet (a Liver function test, repeat Renal function testing along with Color Doppler study of the venous systems of the lower limbs, electrolytes mainly Sodium, Potassium, Calcium, Uric acid will be helpful to rule out other important causes).. if these came out normal also, then after a local examination it can decided if it's due to dependent edema of the body parts or not..

Try to keep your feet little elevated while sleeping (a big pillow underneath the feet will be helpful).. please try not to sit keeping the feet down, yes keeping them elevated will be helpful..

Now, even though your on Toprol for PACs, it'd be a good time now to undergo for a 24 hour holter monitoring and a stress test to rule out any relevant underlying findings in cardiac rhythm as well as any dysregulation in the cardiac circulation..

No, even I disagree with sleep apnea as it's certainly not a probable diagnosis in this scenario..

Please discuss these with your Cardiologist in details, and if there's still any doubts in that front, opting out for another Cardiologist's opinion won't be such a bad idea..

Meanwhile please stay well hydrated by drinking adequate water, try not to get up from bed all of a sudden.. after getting up, try to remain seated for 15 min, then slowly stand up and observe how your feeling..

Let me know how you stay in the due course..any further queries are most welcome..

Take Care
Kind Regards

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Brief Answer:
Yes , please do so.... I'm glad to help you out also..

Detailed Answer:
Hello XXXX,
Welcome back and thanks for following up,

Don't worry about it, and as I've already mentioned, even I disagree with sleep apnoea as it's certainly not a probable diagnosis in this scenario..

Please discuss these with your Cardiologist in details, and if there's still any doubts in that front, opting out for another Cardiologist's opinion won't be such a bad idea..

Meanwhile please stay well hydrated by drinking adequate water, try not to get up from bed all of a sudden.. after getting up, try to remain seated for 15 min, then slowly stand up and observe how your feeling..

Let me know how you stay in the due course..any further queries are most welcome..


For future reference you can always get in touch with me, below is my Direct follow-up link through which you can contact me directly anytime anywhere, I'll be happy to help -

http://www.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=71041

Take Care
Kind Regards

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