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Suggest Treatment For Weakness And Lightheadedness While Having Gluten Intolerance
Question: I believe I need a electro-cardio professional to reply. I do not wish to pay any other professional for advise for this one. My family doc suggested I go to the E.R. and possibly get holter.
For one week I have been having very low bp's...for me they are low, averaging 102 to 115 over 58 to 65. I am normally more like 120 to 135 over 75 to 82 off hand. I also have intermittent weak pulse. I visited the E.R. Thurs. at noon and was fitted for a holter monitor. Since then I have recorded a number of events which I suppose u would call light headedness, altho I call it feeling like I may slip into unconsciousness (or die even...that is fear.). I tried some cayenne pepper yesterday starting at 3.30 p.m on suggestion of doctor friend who said it could be a blockage causing these symptoms. In a bit I will return the holter monitor and come home. It is a Sat. and so there are unlkely any electro cardio guys at the hospital who will read this monitor. I am unhinged by this and fearful of hospitalization as too much is about drugs and surgeries there. I have had copious loose stools altho it may be associated with my gluten intolerance and or sibo. What else can I share that would be helpful? XXXX
For one week I have been having very low bp's...for me they are low, averaging 102 to 115 over 58 to 65. I am normally more like 120 to 135 over 75 to 82 off hand. I also have intermittent weak pulse. I visited the E.R. Thurs. at noon and was fitted for a holter monitor. Since then I have recorded a number of events which I suppose u would call light headedness, altho I call it feeling like I may slip into unconsciousness (or die even...that is fear.). I tried some cayenne pepper yesterday starting at 3.30 p.m on suggestion of doctor friend who said it could be a blockage causing these symptoms. In a bit I will return the holter monitor and come home. It is a Sat. and so there are unlkely any electro cardio guys at the hospital who will read this monitor. I am unhinged by this and fearful of hospitalization as too much is about drugs and surgeries there. I have had copious loose stools altho it may be associated with my gluten intolerance and or sibo. What else can I share that would be helpful? XXXX
Brief Answer:
Further tests and, maybe, treatment required
Detailed Answer:
Greetings and welcome to HCM. I understand your concerns. Thank you for your question.
Well, normal blood pressure is 100-139/60-89 mmHg. My opinion is that the symptoms, as you are describing them, do not come from your blood pressure as it would take a severe blood pressure lowering to produce those symptoms.
Now, the symptoms of weakness, lightheadedness and the sense of slipping, all may come due to problems that are associated with low output of blood to the central nervous system circulation. If you were my patient, I would hospitalize you and keep you under monitor while all the tests were done. These symptoms may come due to a problem in the conduction system of the heart, associated with blocks and/or pauses of conduction, due to a valvular apparatus stenosis or regurgitation (narrowing or back flow of the blood), or due to narrowing of the neck (carotid) arteries. Of course, there may be other reason, but these are the "usual suspects".
Furthermore, I would recommend a total cardiac check-up to confirm/exclude the above mentioned culprits of your situation:
- an EKG, to assess the conduction system of the heart at resting state,
- an echo cardiogram - to carefully evaluate the structures of the heart (chambers and valves), by means of function, motility and size, and whether there are or are not present valvular stenosis or regurgitation,
- a 24-hour Holter rhythm monitor (which is already in-place) - to evaluate whether there are blocks or pauses on the heart conduction
- an echo Doppler of the carotid arteries to see if there is any blockage in these arteries, which would mean that less blood goes to the brain and the symptoms are produced.
Whichever the case, further treatment would be recommended. The most usual, defects in the conduction system of the heart, would require a pacemaker implantation, which would be a definite solution to the situation.
I hope I was of help, with my answer. I am happy to help if you have follow-up questions.
Kind regards,
Dr. Meriton
Further tests and, maybe, treatment required
Detailed Answer:
Greetings and welcome to HCM. I understand your concerns. Thank you for your question.
Well, normal blood pressure is 100-139/60-89 mmHg. My opinion is that the symptoms, as you are describing them, do not come from your blood pressure as it would take a severe blood pressure lowering to produce those symptoms.
Now, the symptoms of weakness, lightheadedness and the sense of slipping, all may come due to problems that are associated with low output of blood to the central nervous system circulation. If you were my patient, I would hospitalize you and keep you under monitor while all the tests were done. These symptoms may come due to a problem in the conduction system of the heart, associated with blocks and/or pauses of conduction, due to a valvular apparatus stenosis or regurgitation (narrowing or back flow of the blood), or due to narrowing of the neck (carotid) arteries. Of course, there may be other reason, but these are the "usual suspects".
Furthermore, I would recommend a total cardiac check-up to confirm/exclude the above mentioned culprits of your situation:
- an EKG, to assess the conduction system of the heart at resting state,
- an echo cardiogram - to carefully evaluate the structures of the heart (chambers and valves), by means of function, motility and size, and whether there are or are not present valvular stenosis or regurgitation,
- a 24-hour Holter rhythm monitor (which is already in-place) - to evaluate whether there are blocks or pauses on the heart conduction
- an echo Doppler of the carotid arteries to see if there is any blockage in these arteries, which would mean that less blood goes to the brain and the symptoms are produced.
Whichever the case, further treatment would be recommended. The most usual, defects in the conduction system of the heart, would require a pacemaker implantation, which would be a definite solution to the situation.
I hope I was of help, with my answer. I am happy to help if you have follow-up questions.
Kind regards,
Dr. Meriton
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
Yes as to the brief answer: those are obvious to me;
Re. the echo and doppler, I agree and these are also obvious and more is the pity that when I was in the E.R. on Thursday these were not ordered.. Thing is this is a week end and none of those are options, even in the hospital if I am not mistaken, so sitting in there unable to get gluten free food , making numerous trips to a foreign toilet and dealing with the humiliation of endless odorous gasses that sometimes come on and dealing with the ineptitude of the people around me in general would prob'ly put me over the top. :)
Re. the following:
conduction system of the heart, associated with blocks and/or pauses of conduction, due to a valvular apparatus stenosis or regurgitation (narrowing or back flow of the blood), or due to narrowing of the neck (carotid) arteries. Of course, there may be other reason, but these are the "usual suspects".
If I substitute "blood flow" for conduction, maybe I can understand better. And sounds like you would be looking for a valve issue in the heart or a narrowing of an artery...the latter would be preferable to my mind and easier to correct altho not by standard mainstream medicine I suppose.
Why do you conclude that a pacemaker would be the solution to one of the two conduction issues?
You do not mention electrical issues at all; nor do I hear tests pertaining thereto. why is that?
I have a diet btw that is exceptional compared to most, rarely eating any junk food...of course I have not achieved 100% in observing good nutrition. And while there is a history of this heart crap in my now deceased and very chubby sister as well as congestive heart in my now deceased twin brother, I have only had history of atrial fib...lone atrial fib that is. I thought it had mitigated of late but while wearing the monitor I became aware of either fibrillating or afib if they are not the same.
Please reply to the above, Doctor.
Thank you, XXXX
BTW, the foregoing was prepared earlier but the site or my computer would not allow it to be sent until just now.
:)
Mitral valve?
Well, it is 7pm where I am and I hope to receive a timely reply before i have to retire.
XXXX
Re. the echo and doppler, I agree and these are also obvious and more is the pity that when I was in the E.R. on Thursday these were not ordered.. Thing is this is a week end and none of those are options, even in the hospital if I am not mistaken, so sitting in there unable to get gluten free food , making numerous trips to a foreign toilet and dealing with the humiliation of endless odorous gasses that sometimes come on and dealing with the ineptitude of the people around me in general would prob'ly put me over the top. :)
Re. the following:
conduction system of the heart, associated with blocks and/or pauses of conduction, due to a valvular apparatus stenosis or regurgitation (narrowing or back flow of the blood), or due to narrowing of the neck (carotid) arteries. Of course, there may be other reason, but these are the "usual suspects".
If I substitute "blood flow" for conduction, maybe I can understand better. And sounds like you would be looking for a valve issue in the heart or a narrowing of an artery...the latter would be preferable to my mind and easier to correct altho not by standard mainstream medicine I suppose.
Why do you conclude that a pacemaker would be the solution to one of the two conduction issues?
You do not mention electrical issues at all; nor do I hear tests pertaining thereto. why is that?
I have a diet btw that is exceptional compared to most, rarely eating any junk food...of course I have not achieved 100% in observing good nutrition. And while there is a history of this heart crap in my now deceased and very chubby sister as well as congestive heart in my now deceased twin brother, I have only had history of atrial fib...lone atrial fib that is. I thought it had mitigated of late but while wearing the monitor I became aware of either fibrillating or afib if they are not the same.
Please reply to the above, Doctor.
Thank you, XXXX
BTW, the foregoing was prepared earlier but the site or my computer would not allow it to be sent until just now.
:)
Mitral valve?
Well, it is 7pm where I am and I hope to receive a timely reply before i have to retire.
XXXX
Brief Answer:
My follow-up would be as described:
Detailed Answer:
Hello again and welcome back.
Well, I was merely listing the main possible culprits related to the heart and circulation system, which would describe your symptomatic phenomena. Pacemaker is not indicated for electrical problems. You see, an electrical impulse is generated normally, but not conducted properly, therefore blocks and/or pauses may be produced. As about the valve, I was more referring to the aortic valve. As you may understand, I listed the above mentioned tests, because, although I have a clear picture of the situation, we need to have the tests to confirm or exclude the main problem or other problems.
I hope my follow-up is helpful. Kindly, if you do not have further close the discussion and rate the answer.
Best regards,
Dr. Meriton
My follow-up would be as described:
Detailed Answer:
Hello again and welcome back.
Well, I was merely listing the main possible culprits related to the heart and circulation system, which would describe your symptomatic phenomena. Pacemaker is not indicated for electrical problems. You see, an electrical impulse is generated normally, but not conducted properly, therefore blocks and/or pauses may be produced. As about the valve, I was more referring to the aortic valve. As you may understand, I listed the above mentioned tests, because, although I have a clear picture of the situation, we need to have the tests to confirm or exclude the main problem or other problems.
I hope my follow-up is helpful. Kindly, if you do not have further close the discussion and rate the answer.
Best regards,
Dr. Meriton
Above answer was peer-reviewed by :
Dr. Sonia Raina
Dear Dr.,
so...you were saying that electrical could be the issue just as well as the other suggestions could (as far as we know until further tests) and could cause blockages of ...blood or impulses???
And as far as it goes your best guess would still be aortic?
Tell me if I am understanding you at all.
Thank you, XXXX
And if this were an aortic blockage would the best thing be resting for now until dx'd and avoiding exercise??
Even though the bp does not cause the issues....what is the relationship then? It is DEFINITELY low for me and a part of this whole complex issue. How does it figure in?
so...you were saying that electrical could be the issue just as well as the other suggestions could (as far as we know until further tests) and could cause blockages of ...blood or impulses???
And as far as it goes your best guess would still be aortic?
Tell me if I am understanding you at all.
Thank you, XXXX
And if this were an aortic blockage would the best thing be resting for now until dx'd and avoiding exercise??
Even though the bp does not cause the issues....what is the relationship then? It is DEFINITELY low for me and a part of this whole complex issue. How does it figure in?
Brief Answer:
Merely listed the possible causes
Detailed Answer:
Hi again.
I merely listed the possible causes of your symptoms (the main causes), since we do not posses the results of the tests which I recommended in the original answer.
Now, a blood pressure that would produce such symptoms, should at least be under 80 systolic, which means a decreased blood ejection to satisfy the need of the periphery. About the symptoms, they are all symptoms that suggest low blood flow to the central nervous system. There are many causes that could be associated with this phenomenon, but the main three were listed in my original answer: conduction abnormalities (during which, heart "stops" for few second, therefore no blood is pumped, therefore brain is not perfused - symptoms are generated); aortic stenosis (heart pumps normally, but due to the narrowing of the aortic valve not all the blood goes to the periphery - symptoms are produced); and blockages in the neck arteries (no sufficient blood to the brain - symptoms are produced). Basically, the mechanism of your symptoms is the same, but causes are different, and due to the possible culprit cause, the tests recommended should be carried out to be sure which it is, and the treatment will be suggested according to the correct culprit. That is why, if you would be my patient, I would have you hospitalized, and in a few days, I would carry out all the mentioned tests to confirm, or hopefully, exclude anything that could be wrong.
I hope my follow-up is helpful and thorough.
Regards
Dr. Meriton
Merely listed the possible causes
Detailed Answer:
Hi again.
I merely listed the possible causes of your symptoms (the main causes), since we do not posses the results of the tests which I recommended in the original answer.
Now, a blood pressure that would produce such symptoms, should at least be under 80 systolic, which means a decreased blood ejection to satisfy the need of the periphery. About the symptoms, they are all symptoms that suggest low blood flow to the central nervous system. There are many causes that could be associated with this phenomenon, but the main three were listed in my original answer: conduction abnormalities (during which, heart "stops" for few second, therefore no blood is pumped, therefore brain is not perfused - symptoms are generated); aortic stenosis (heart pumps normally, but due to the narrowing of the aortic valve not all the blood goes to the periphery - symptoms are produced); and blockages in the neck arteries (no sufficient blood to the brain - symptoms are produced). Basically, the mechanism of your symptoms is the same, but causes are different, and due to the possible culprit cause, the tests recommended should be carried out to be sure which it is, and the treatment will be suggested according to the correct culprit. That is why, if you would be my patient, I would have you hospitalized, and in a few days, I would carry out all the mentioned tests to confirm, or hopefully, exclude anything that could be wrong.
I hope my follow-up is helpful and thorough.
Regards
Dr. Meriton
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Above answer was peer-reviewed by :
Dr. Vaishalee Punj
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